Provider Demographics
NPI:1750304713
Name:STAGGERS, HEARE, & WHITEMAN, P.A.
Entity Type:Organization
Organization Name:STAGGERS, HEARE, & WHITEMAN, P.A.
Other - Org Name:PROGRESSIVE PHYSICAL THERAPY & REHABILITATION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:ROSS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-729-3485
Mailing Address - Street 1:22278 NORTHWESTERN PIKE
Mailing Address - Street 2:
Mailing Address - City:ROMNEY
Mailing Address - State:WV
Mailing Address - Zip Code:26757-8005
Mailing Address - Country:US
Mailing Address - Phone:304-822-6024
Mailing Address - Fax:304-822-7989
Practice Address - Street 1:22278 NORTHWESTERN PIKE
Practice Address - Street 2:
Practice Address - City:ROMNEY
Practice Address - State:WV
Practice Address - Zip Code:26757-8005
Practice Address - Country:US
Practice Address - Phone:304-822-6024
Practice Address - Fax:304-822-7989
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-25
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV001739581OtherMOUNTAIN STATE BCBS
WV3810005449Medicaid
MDS986OtherCAREFIRST BCBS
222830OtherMAMSI