Provider Demographics
NPI:1790765154
Name:OASIS PHYSICAL THERAPY & REH
Entity Type:Organization
Organization Name:OASIS PHYSICAL THERAPY & REH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:SUE
Authorized Official - Last Name:GIAMBATTISTA
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:937-436-3440
Mailing Address - Street 1:7810 MCEWEN RD
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45459-4077
Mailing Address - Country:US
Mailing Address - Phone:937-436-3440
Mailing Address - Fax:937-436-3442
Practice Address - Street 1:7810 MCEWEN RD
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45459-4077
Practice Address - Country:US
Practice Address - Phone:937-436-3440
Practice Address - Fax:937-436-3442
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-20
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT10310225100000X, 2251P0200X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatricsGroup - Single Specialty
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000328817OtherANTHEM BCBS
OHPT206OtherHUMANA
OH2601116Medicaid
OH=========OtherUNITED MEDICAL RESOURCES
OH=========OtherHEALTH SPAN
OH2601116Medicaid
OH=========OtherPRIMARY HEALTH SERVICES
OH=========OtherCHANDLER GROUP
OH=========OtherPLAN VISTA
OHPT206OtherHUMANA
OH000000328817OtherANTHEM BCBS
OH000000328817OtherANTHEM BCBS