FAYETTEVILLE PHYSICAL THERAPY & SPORTS REHABILITATION
NPI 1003994054
Specialist in Fayetteville, WV

Q: What is Fayetteville Physical Therapy & Sports Rehabilitation's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Active since November 01, 2006

233 N COURT ST, FAYETTEVILLE, WV 25840(304) 574-1416(304) 574-1474 Get Directions Write a Review

NPPES record last updated: January 8, 2008. Verified against the NPPES registry weekly; last sync: November 01, 2026.

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About Fayetteville Physical Therapy & Sports Rehabilitation NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

FAYETTEVILLE PHYSICAL THERAPY & SPORTS REHABILITATION (NPI 1003994054) is a healthcare organization registered as a specialist in Fayetteville, West Virginia and active in the NPI registry since November 2006. The organization lists Karen M Brandstetter, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1003994054

Entity TypeOrganization

Primary Taxonomy174400000X

Legal Business NameFAYETTEVILLE PHYSICAL THERAPY & SPORTS REHABILITATION

Location Address233 N COURT STFayetteville, WV 25840-1233

Mailing Address233 N Court StFayetteville, WV 25840-1233 · (304) 574-1416 · Fax (304) 574-1474

Phone(304) 574-1416

Fax(304) 574-1474

Organization SubpartNo

Authorized OfficialKaren M BrandstetterOffice Manager · (304) 574-1416

Enumeration DateNovember 1, 2006

Last NPPES UpdateJanuary 8, 2008

✔ NPI 1003994054 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers

Taxonomy Code174400000X

License✔ Licensed in WV · WV902

Definition

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.

233 N COURT ST, Fayetteville, WV 25840

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Other Identifiers 3

Medicare ID-Type UnspecifiedMU0751821WV · Medicare Provider Number

Other1459717WV · Umwa

Medicaid0156959000WV

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Highmark Blue Cross Blue Shield West Virginia.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Fayetteville Physical Therapy & Sports Rehabilitation is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 2 clinicians reassign Medicare billing to Fayetteville Physical Therapy & Sports Rehabilitation, which bills Medicare for the services they deliver. Of these, 1 practice at this address. They are listed nearest first.

Clinicians, nearest first (2)

Lisa Harris, P.T.

Physical Therapist in Private Practice

NPI 1235314378

233 N COURT ST
Fayetteville, WV 25840

(304) 574-1416

✔ Accepts MedicareSame address

Isabel Bosso, DPT

Physical Therapist in Private Practice

NPI 1902232580

900 JOHNNIE DODDS BLVD
Mount Pleasant, SC 29464

(843) 606-1490

368 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Fayetteville Physical Therapy & Sports Rehabilitation's NPI number?

The NPI number for Fayetteville Physical Therapy & Sports Rehabilitation is 1003994054. It was assigned to this organization in the NPPES registry on November 1, 2006.

Where is Fayetteville Physical Therapy & Sports Rehabilitation located?

Fayetteville Physical Therapy & Sports Rehabilitation is located at 233 N Court St, Fayetteville, WV 25840. The listed phone number is (304) 574-1416.

What is Fayetteville Physical Therapy & Sports Rehabilitation's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Is Fayetteville Physical Therapy & Sports Rehabilitation enrolled in Medicare?

Yes. Fayetteville Physical Therapy & Sports Rehabilitation is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Fayetteville Physical Therapy & Sports Rehabilitation?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Physical Therapist in Private Practice, reassign their Medicare billing to Fayetteville Physical Therapy & Sports Rehabilitation. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 1 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Fayetteville Physical Therapy & Sports Rehabilitation accept?

Health plans from Highmark Blue Cross Blue Shield West Virginia list Fayetteville Physical Therapy & Sports Rehabilitation as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Fayetteville Physical Therapy & Sports Rehabilitation was last updated on January 8, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.