Gauley River Physical Therapy and Rehabilitation, LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

GAULEY RIVER PHYSICAL THERAPY AND REHABILITATION, LLC

Practice address

704 Professional Park Dr
Suite B
Summersville, WV 26651-2000

Phone

(304) 872-0490

Fax

(304) 872-0492

NPI assigned

May 3, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Arthur John Smith Jr., P.T.

Title

Co-Administrator

Phone

(304) 872-0490

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1992927180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "704 PROFESSIONAL PARK DR STE B",
            "city": "SUMMERSVILLE",
            "state": "WV",
            "postal_code": "266512000",
            "telephone_number": "304-872-0490",
            "fax_number": "304-872-0492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "704 PROFESSIONAL PARK DR",
            "address_2": "SUITE B",
            "city": "SUMMERSVILLE",
            "state": "WV",
            "postal_code": "266512000",
            "telephone_number": "304-872-0490",
            "fax_number": "304-872-0492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GAULEY RIVER PHYSICAL THERAPY AND REHABILITATION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "ARTHUR",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "CO-ADMINISTRATOR",
        "authorized_official_telephone_number": "304-872-0490",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "WV",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0157391000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Summersville, WV
• Providers in Summersville, WV by specialty
• Physical Therapist in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.