Organization Active NPI

Summit Physical Therapy Inc

  • Physical Therapy Clinic/Center
  • Weirton, WV
National Provider Identifier
1912918079
Registry record updated Apr 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
SUMMIT PHYSICAL THERAPY INC
Practice address
414 Penco Rd
Weirton, WV 26062
Phone
(304) 723-3780
Fax
(304) 723-4110
NPI assigned
Aug 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mark W Mascio, LPT
Title
VP
Phone
(304) 723-3780

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

414 Penco Rd
Weirton, WV 26062

Mailing address

414 Penco Rd
Weirton, WV 26062
Phone (304) 723-3780

Other identifiers 1

IdentifierTypeStateIssuer
3810004836MedicaidWV

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1912918079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "414 PENCO RD",
            "city": "WEIRTON",
            "state": "WV",
            "postal_code": "26062",
            "telephone_number": "304-723-3780",
            "fax_number": "304-723-4110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "414 PENCO RD",
            "city": "WEIRTON",
            "state": "WV",
            "postal_code": "26062",
            "telephone_number": "304-723-3780",
            "fax_number": "304-723-4110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT PHYSICAL THERAPY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-11",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "MASCIO",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "304-723-3780",
        "authorized_official_credential": "LPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810004836",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Weirton, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.