Potential Physical Therapy LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

POTENTIAL PHYSICAL THERAPY LLC

Practice address

134 Lancaster Ave
Malvern, PA 19355-2123

Phone

(610) 249-0001

NPI assigned

Jun 8, 2018

Organization subpart

No

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

Authorized official

Name

Supriya S MulikNPI 1871969410

Title

PT

Phone

(610) 249-0001

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Supriya S Mulik

  • Physical Therapist
  • Phoenixville, PA
  • NPI 1871969410
  Medicare reassignment NPD Authorized official
• Ruchi Parul Shah, MS, DPT,OCS,CMP

  • Orthopedic Physical Therapist
  • Malvern, PA
  • NPI 1841675147
  Medicare reassignment

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

{
    "created_epoch": "1528416000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598832000000",
    "number": "1922591536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "134 LANCASTER AVE",
            "city": "MALVERN",
            "state": "PA",
            "postal_code": "193552123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "134 LANCASTER AVE",
            "city": "MALVERN",
            "state": "PA",
            "postal_code": "193552123",
            "telephone_number": "610-249-0001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POTENTIAL PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-08",
        "last_updated": "2020-08-31",
        "certification_date": "2020-08-31",
        "status": "A",
        "authorized_official_last_name": "MULIK",
        "authorized_official_first_name": "SUPRIYA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PT",
        "authorized_official_telephone_number": "610-249-0001"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "PT023984",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alexa Piantone, PHARMD
• Stephanie Brooks Pirozzi, LPC
• Playfull Therapy
• Bonnie Lynn Pluta, M.S., BCBA, BSL
• Laura Pogue, M.S., L.P.C., N.C.C.
• Premier Orthopaedic and Sports Medicine
• Premier Orthopaedic and Sports Medicine Assoc
• Premier Rehabilitation Center Inc
• Premise Health of Pennsylvania Medical PC
• Premise Health of Pennsylvania Medical PC

• Physical Therapist in Malvern, PA
• Providers in Malvern, PA by specialty
• Physical Therapist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.