Active NPI
Fernando Villa
- Physical Therapist
- Indianapolis, IN
National Provider Identifier
1053416073
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 05003515A
- Practice address
- 5980 W 71St St Ste 201
Indianapolis, IN 46278-1785 - Phone
- (317) 388-0800
- NPI assigned
- Sep 14, 2006
- Sex
- Male
- 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 | 05003515A | IN | Primary |
Addresses
Primary practice location
5980 W 71St St Ste 201
Indianapolis, IN 46278-1785
Mailing address
21218 Carlton CT
Noblesville, IN 46062-8001
Phone (317) 877-0098
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 05003515A | IN | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Access Therapies at Home | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Non-Pharmacy Dispensing Site
- Indianapolis, IN
- NPI 1255364758
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158192000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1053416073",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21218 CARLTON CT",
"city": "NOBLESVILLE",
"state": "IN",
"postal_code": "460628001",
"telephone_number": "317-877-0098"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5980 W 71ST ST STE 201",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462781785",
"telephone_number": "317-388-0800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VILLA",
"first_name": "FERNANDO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IN",
"license": "05003515A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.