Active NPI
Casie Marie Phetteplace, DPT
- Physical Therapist
- Leonardtown, MD
National Provider Identifier
1013531029
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 26060
- Practice address
- 40845 Merchants LN
Leonardtown, MD 20650-3767 - Phone
- (240) 530-8188
- Fax
- (301) 638-0470
- NPI assigned
- Jun 4, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 26060 | MD | Primary |
Addresses
Primary practice location
40845 Merchants LN
Leonardtown, MD 20650-3767
Mailing address
40845 Merchants LN
Leonardtown, MD 20650-3767
Phone (240) 530-8188
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1591228800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1591228800000",
"number": "1013531029",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "40845 MERCHANTS LN",
"city": "LEONARDTOWN",
"state": "MD",
"postal_code": "206503767",
"telephone_number": "240-530-8188",
"fax_number": "301-638-0470"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "40845 MERCHANTS LN",
"city": "LEONARDTOWN",
"state": "MD",
"postal_code": "206503767",
"telephone_number": "240-530-8188",
"fax_number": "301-638-0470"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHETTEPLACE",
"first_name": "CASIE",
"middle_name": "MARIE",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-06-04",
"last_updated": "2020-06-04",
"certification_date": "2020-06-04",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MD",
"license": "26060",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Leonardtown, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.