MOUNTAIN STATE PHYSICAL THERAPY LLC (NPI# 1083668875) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083668875 |
| Entity Type | Organization |
| Organization Name | MOUNTAIN STATE PHYSICAL THERAPY LLC |
| Other Organization Name | MOUNTAIN STATE PHYSICAL THERAPY |
| Practice Address |
719 Fairmont Ave Suite 102 Fairmont WV 26554-5118 |
| Practice Telephone | 3043638543 |
| Practice Fax Number | 3043630173 |
| Mailing Telephone | 3043638543 |
| Mailing Fax Number | 3043630173 |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2019-05-23 |
| Authorized Official Name | ANDREW J. BARRISH (PRESIDENT) |
| Authorized Official Telephone | 3043638543 |
| Authorized Official Credential | PT |
| 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 |
|---|---|---|---|
| WV | 0202606000 | 05 | |
| RAILROAD MEDICARE | DB3679 | 01 |
| Other Name | Type Code |
|---|---|
| Dino Rovito Etal Ptr | Former Legal Business Name - Organization |
| Mountain State Physical Therapy | Doing Business As Name - Organization |
| Street Address |
719 FAIRMONT AVE SUITE 102 |
| City | FAIRMONT |
| State | WV |
| Zip Code | 26554-5118 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609383157 | Deborah L Barnes | Hearing Instrument Specialist | 719 Fairmont Ave, Ste 203, Fairmont, WV 26554 | 2018-01-05 |
| 1194178798 | Maximillian Von Doemming | Hearing Instrument Specialist | 719 Fairmont Ave, 203, Fairmont, WV 26554-5118 | 2016-07-19 |
| 1124401963 | Gabriel Wilson | Physical Therapist | 719 Fairmont Ave, Suite 102, Fairmont, WV 26554-5118 | 2015-06-29 |
| 1932506698 | Kelley Elizabeth Kluender | Physical Therapist | 719 Fairmont Ave, #102, Fairmont, WV 26554-5118 | 2014-11-24 |
| 1982977989 | Amy M Lancaster | Physical Therapist | 719 Fairmont Ave, Suite 102, Fairmont, WV 26554 | 2012-02-22 |
| 1881967883 | Patrick Snell | Physical Therapist | 719 Fairmont Ave, Ste 102, Fairmont, WV 26554 | 2012-02-22 |
| 1144260183 | Renee Riffle Mcginnis | Physical Therapist | 719 Fairmont Ave, Suite 102, Fairmont, WV 26554-5118 | 2006-06-07 |
| 1427004191 | Andrew J. Barrish | Physical Therapist | 719 Fairmont Ave, Fairmont, WV 26554-5118 | 2006-05-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801497680 | Vanquisha Clay | Technician | 118 Conaway St, Fairmont, WV 26554 | 2020-11-06 |
| 1851903363 | Denise S Greer | Technician | 1029 Prickett Road, Fairmont, WV 26554 | 2020-08-18 |
| 1730790775 | Darla Lee Mcrobie | Technician | 105 C'anna Square, Fairmont, WV 26554 | 2020-08-13 |
| 1376025718 | Jason Batten | Counselor | 621 Maryland Ave, Fairmont, WV 26554 | 2018-09-02 |
| 1437669066 | Ultimate Health & Wellness, LLC | Naturopath | 2862 Whitehall Blvd, Whitehall, WV 26554 | 2017-10-10 |
| 1457872376 | Michele R Lilley | Nurse Practitioner | 177 Middletown Rd, Ste1, Upc Whitehall Medical, Fairmont, WV 26554 | 2017-06-30 |
| 1477906154 | Rebecca Hayes-merrill | Counselor | 212 Adams St., 3rd Floor, Fairmont, WV 26554 | 2016-07-19 |
| 1790173417 | Dennis Michael Lynch | Counselor | 5 Turf Lane, Fairmont, WV 26554 | 2015-01-05 |
| 1336558725 | Nicole Savage | Home Health Aide | 122 Abbott St, Fairmont, WV 26554 | 2014-08-11 |
| 1124434550 | Achuta Ram Aynampudi | Psychiatry & Neurology | 100 Stoney Hill Rd, Fairmont, WV 26554 | 2014-07-07 |
| Find all providers in zip 26554 | ||||
| Taxonomy Code | 261QP2000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Physical Therapy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770792509 | Baby Step, LLC | Clinic/Center | 1 Hidden Trails Estate, Fairmont, WV 26554 | 2007-05-21 |
| 1992314280 | Mountain River Physical Therapy, LLC | Clinic/Center | 1900 Locust Ave Ste A, Fairmont, WV 26554-1293 | 2020-07-23 |
| 1538262597 | Monongahela Valley Association of Health Centers Inc | Clinic/Center | 1322 Locust Ave, Fairmont, WV 26555-1112 | 2006-09-06 |
| 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 |
| Find all providers with the same taxonomy | ||||
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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.