MOUNTAIN RIVER PHYSICAL THERAPY LLC (NPI# 1164438487) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164438487 |
| Entity Type | Organization |
| Organization Name | MOUNTAIN RIVER PHYSICAL THERAPY LLC |
| Practice Address |
117 W. Wagner Street Ellenboro WV 26346 |
| Mailing Address |
415 36th St Suite 100 Parkersburg WV 26101-1005 |
| Practice Telephone | 3048693888 |
| Practice Fax Number | 3048693444 |
| Mailing Telephone | 3049173660 |
| Mailing Fax Number | 3049173674 |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2016-05-27 |
| Authorized Official Name | BURTON R REED (OWNER/PT) |
| Authorized Official Telephone | 3048656778 |
| Authorized Official Credential | PT, OCS, FAAOMPT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
WV | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MEDICARE ID TYPE UNSPEC | DA4403 | 01 | |
| OH | 2701786 | 05 | |
| WV | 3810006084 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720538200 | Mountain River Physical Therapy LLC | Clinic/Center | 3407 Jackson Ave, Point Pleasant, WV 25550-1827 | 2016-10-10 |
| 1336483627 | Mountain River Physical Therapy LLC | Clinic/Center | 344b Church St S, Ripley, WV 25271-1512 | 2012-11-27 |
| 1710182274 | Mountain River Physical Therapy LLC | Clinic/Center | 174 N State Route 2, Suite 2, New Martinsville, WV 26155-1604 | 2007-06-15 |
| 1255347571 | Mountain River Physical Therapy LLC | Clinic/Center | 63 Hospitality Lane, Suite 1, Mineral Wells, WV 26150 | 2006-07-31 |
| 1447673165 | Mountain River Physical Therapy LLC | Clinic/Center | 252 W Main St, Suite E, Saint Clairsville, OH 43950-1061 | 2014-01-31 |
| 1093053225 | Mountain River Physical Therapy LLC | Clinic/Center | 1720 Se 16th Ave, Suite 302, Ocala, FL 34471-4620 | 2013-01-23 |
| 1407165830 | Mountain River Physical Therapy LLC | Clinic/Center | 47 Depot Street, Chatham, VA 24531-0000 | 2010-10-04 |
| 1669797395 | Mountain River Physical Therapy LLC | Clinic/Center | 2101 E State St, Suite C, Athens, OH 45701-2143 | 2010-04-06 |
| 1154555241 | Mountain River Physical Therapy LLC | Clinic/Center | 416 37th St, Parkersburg, WV 26101-1009 | 2009-05-05 |
| 1710135306 | Mountain River Physical Therapy LLC | Clinic/Center | 5479 Pottsville Pike, Suite 200, Leesport, PA 19533-8650 | 2008-09-08 |
| Street Address |
117 W. WAGNER STREET |
| City | ELLENBORO |
| State | WV |
| Zip Code | 26346 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871942318 | Andrew George Costaras | Physical Therapist | 117 W. Wagner Street, Ellenboro, WV 26346-0328 | 2016-06-06 |
| 1275993065 | Wesley Kirk Eades | Physical Therapist | 117 W. Wagner Street, Ellenboro, WV 26346-0328 | 2016-03-07 |
| 1619368669 | Richard A. Gandee II | Physical Therapist | 117 W. Wagner Street, Ellenboro, WV 26346-0328 | 2015-02-12 |
| 1164613782 | Stephanie Marie Foutty | Physical Therapist | 117 W. Wagner Street, Ellenboro, WV 26346-0328 | 2007-08-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235657966 | Ashley Nichole Mullenix | Nurse Practitioner | 107 Ritchie County School Road, Ellenboro, WV 26346 | 2017-09-01 |
| 1134316086 | Lucky Eye Care, Pllc | Eyewear Supplier (Equipment, not the service) | 123 West Wagner, Ellenboro, WV 26346 | 2007-09-25 |
| 1518083070 | Ritchie County Primary Care Assoc Inc | Clinic/Center | 107 Ritchie Co School Road, Ellenboro, WV 26346 | 2007-03-22 |
| 1386657013 | Nicole Deann Sleeth | Physical Therapist | 117 West Wagner Street, Ellenboro, WV 26346 | 2006-08-14 |
| 1093225385 | Ritchie County Primary Care Assoc Inc | Clinic/Center | 100 School St, Ellenboro, WV 26346 | 2017-10-02 |
| 1669893780 | Thomas Knotts | Specialist/Technologist | 201 Ritchie County School Rd Ste 1, Ellenboro, WV 26346-6704 | 2013-12-16 |
| Taxonomy Code | 261QP2000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Physical Therapy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811594757 | Mountain River Physical Therapy, LLC | Clinic/Center | 108 Osprey Drive, Suite B, Williamstown, WV 26187 | 2020-10-05 |
| 1376140210 | Mountain River Physical Therapy, LLC | Clinic/Center | 415 36th St Ste 100, Parkersburg, WV 26101-1005 | 2020-10-05 |
| 1497362867 | Pelvic Health Physical Therapy of Morgantown, LLC | Clinic/Center | 6000 Coombs Farm Rd Ste 106, Morgantown, WV 26508-1155 | 2020-09-29 |
| 1972136786 | Pocahontas Memorial Hospital | Clinic/Center | 16023 Cass Rd, Cass, WV 24927-9136 | 2020-02-20 |
| 1124667613 | Move Right Performance Therapy | Clinic/Center | 330 Scott Ave, Morgantown, WV 26508-0023 | 2019-12-31 |
| 1932744240 | Mountain River Physical Therapy, LLC | Clinic/Center | 483 Court St Ste 1, Elizabeth, WV 26143-1109 | 2019-11-11 |
| 1114562428 | Mountain River Physical Therapy, LLC | Clinic/Center | 606 Washington St Ste 1, Ravenswood, WV 26164-1730 | 2019-11-11 |
| 1508408881 | Jimmie Tyler Beirne | Clinic/Center | 4011 Feely Ln, Ona, WV 25545-9762 | 2019-10-08 |
| 1548801798 | Lenzie Weicht | Clinic/Center | 5724 Hammonds Mill Rd Ste G, Martinsburg, WV 25404-6491 | 2019-09-30 |
| 1477107183 | First Settlement Physical Therapy | Clinic/Center | 2909c 7th St, Parkersburg, WV 26101-3808 | 2019-07-31 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.