WYCHOCK PHYSICAL THERAPY INC (NPI# 1295916146) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295916146 |
| Entity Type | Organization |
| Organization Name | WYCHOCK PHYSICAL THERAPY INC |
| Practice Address |
607 Lake Ave Ashtabula OH 44004-3262 |
| Practice Telephone | 4409642035 |
| Practice Fax Number | 4409640699 |
| Mailing Telephone | 4409642035 |
| Mailing Fax Number | 4409640699 |
| Enumeration Date | 2007-11-20 |
| Last Update Date | 2007-11-20 |
| Authorized Official Name | MR. STEPHEN G WYCHOCK (OWNER) |
| Authorized Official Telephone | 4409642035 |
| Authorized Official Credential | PHYSICAL THERAPI |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | PT006573 | OH | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | BLUE CROSS BLUE SHIELD | 000000320301 | 01 |
| OH | 2361699 | 05 | |
| OH | RETIRED RAILROAD MEDICARE | DA9882 | 01 |
| Street Address |
607 LAKE AVE |
| City | ASHTABULA |
| State | OH |
| Zip Code | 44004-3262 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760489413 | Stephen Gerald Wychock | Physical Therapist | 607 Lake Ave, Ashtabula, OH 44004-3262 | 2005-07-07 |
| 1003389271 | Stephanie Marie Corlew | Physical Therapy Assistant | 607 Lake Ave, Ashtabula, OH 44004-3262 | 2019-01-09 |
| 1760738934 | Elizabeth Schlosser | Physical Therapist | 607 Lake Ave, Ashtabula, OH 44004-3262 | 2012-07-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174167050 | Jack Lemmon | Physical Therapist | 2515 Lake Rd E, Ashtabula, OH 44004 | 2019-11-04 |
| 1871060608 | Ahmed Shahata | Obstetrics & Gynecology | Ashtabula County Medical Center/obgyn Dept, 2420 Lake Ave, Ashtabula, OH 44004 | 2018-10-30 |
| 1861999013 | Thomas Webber | Counselor | 2801 C. Court, Ashtabula, OH 44004 | 2018-04-12 |
| 1942702428 | Troy Mills | Hearing Instrument Specialist | 2604 West Prospect Rd, Ashtabula, OH 44004 | 2018-03-01 |
| 1598294886 | Howard Edward Loftus Jr. | Counselor | 4726 Main Ave., Ashtabula, OH 44004 | 2017-06-08 |
| 1861928087 | Hannah Woods | Physical Therapist | 3720 N Ridge Road W, Ashtabula, OH 44004 | 2017-05-08 |
| 1376095422 | Lantern of Saybrook | Assisted Living Facility | 3720 North Ridge Road West, Ashtabula, OH 44004 | 2016-10-25 |
| 1801346366 | Melissa Marie Holland | Licensed Practical Nurse | 2124 W Prospect Rd, Ashtabula, OH 44004 | 2016-10-09 |
| 1184080087 | Kevin M Welsh | Speech-Language Pathologist | 2240 Wade Ave, Ashtabula, OH 44004 | 2016-01-07 |
| 1285021709 | David Hefner | Early Intervention Provider Agency | 600 State Road, Ashtabula, OH 44004 | 2015-04-22 |
| Find all providers in zip 44004 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437154234 | Chandresh S Shah | Specialist | 2420 Lake Ave, Ashtabula, OH 44004-4954 | 2005-06-17 |
| 1568967289 | Octavia Harris | Specialist | 2801 C Ct, Ashtabula, OH 44004-4577 | 2018-03-26 |
| 1629454228 | Kenneth Nicholas Hoopes | Specialist | 416 W 27th St, Ashtabula, OH 44004-4975 | 2015-08-05 |
| 1780060392 | Kasey Lynn Hoopes | Specialist | 416 W 27th St, Ashtabula, OH 44004-4975 | 2015-08-05 |
| 1679991103 | Aloha Hands Bodyworks LLC | Specialist | 615 Lake Ave, Ashtabula, OH 44004-3262 | 2014-04-02 |
| 1649694944 | Lynette Wilden | Specialist | 4200 State Rd, Ashtabula, OH 44004-6017 | 2014-02-07 |
| 1760731426 | Hilda S Jarvis | Specialist | 615 Lake Ave, Ashtabula, OH 44004-3262 | 2012-09-09 |
| 1518105345 | T Matthew Mak Md Inc | Specialist | 2728 Lake Ave, Ashtabula, OH 44004-4960 | 2009-02-02 |
| 1346419066 | State Road Occupational Medical Facility LLC | Specialist | 600 State Rd, Suite 166, Ashtabula, OH 44004-3933 | 2008-02-27 |
| 1629269493 | William S Mirando Md LLC | Specialist | 2885 N Ridge Rd E, Ashtabula, OH 44004-4134 | 2007-08-07 |
| Find all providers in ASHTABULA | ||||
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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.