Individual provider Active NPI

Robert John Henry, M.P.T.

  • Physical Therapist
  • Indiana, PA
National Provider Identifier
1962594697
Registry record updated Jan 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT008069L Issued in PA
Practice address
1916 Oakland Ave
Indiana, PA 15701-3380
Phone
(724) 463-0199
Fax
(724) 463-8944
NPI assigned
Sep 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT008069L PA Primary

Addresses

Primary practice location

1916 Oakland Ave
Indiana, PA 15701-3380

Mailing address

430 Innovation Drive
Blairsville, PA 15717-8096
Phone (724) 343-4060

Other identifiers 4

IdentifierTypeStateIssuer
762948OtherPAHIGHMARK BLUE SHIELD
116948OtherPAHEALTH AMER/HEALTH ASSUR.
2348658700OtherPAHEALTH PLAN OF OHIO VAL.
5087008OtherPAAETNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PT008069LPAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Phoenix Rehabilitation and Health Services, Inc. Physical Therapist Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421193600000",
    "number": "1962594697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 INNOVATION DRIVE",
            "city": "BLAIRSVILLE",
            "state": "PA",
            "postal_code": "157178096",
            "telephone_number": "724-343-4060",
            "fax_number": "724-343-4069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1916 OAKLAND AVE",
            "city": "INDIANA",
            "state": "PA",
            "postal_code": "157013380",
            "telephone_number": "724-463-0199",
            "fax_number": "724-463-8944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENRY",
        "first_name": "ROBERT",
        "middle_name": "JOHN",
        "credential": "M.P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-29",
        "last_updated": "2015-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT008069L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "762948",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH AMER/HEALTH ASSUR.",
            "identifier": "116948",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PLAN OF OHIO VAL.",
            "identifier": "2348658700",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5087008",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indiana, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2015; 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.