Active NPI
Miranda Leanne Rettell, PTA
- Physical Therapy Assistant
- Piper City, IL
National Provider Identifier
1053973669
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 160.006575
- Practice address
- 600 S Maple St
Piper City, IL 60959 - Phone
- (815) 686-2277
- NPI assigned
- Jul 3, 2019
- 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 Therapy Assistant | 225200000X | 160.006575 | IL | Primary |
Addresses
Primary practice location
600 S Maple St
Piper City, IL 60959
Mailing address
600 S Maple St
Piper City, IL 60959-7095
Phone (815) 686-2277
Other practice location 1
350 N Wall St
Kankakee, IL 60901-2901
Phone (815) 933-1671
Other practice location 2
600 S Maple St
Piper City, IL 60959
Phone (815) 686-2277
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | Miranda.rettell@rehabcare.com | ||
| Other URL | Miranda.rettell@rehabecare.com |
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 |
|---|---|---|---|
| 160.006575 | IL | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1562112000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1562112000000",
"number": "1053973669",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "600 S MAPLE ST",
"city": "PIPER CITY",
"state": "IL",
"postal_code": "609597095",
"telephone_number": "815-686-2277"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 S MAPLE ST",
"city": "PIPER CITY",
"state": "IL",
"postal_code": "60959",
"telephone_number": "815-686-2277"
}
],
"practiceLocations": [
{
"address_1": "350 N Wall St",
"address_purpose": "LOCATION",
"city": "Kankakee",
"state": "IL",
"postal_code": "609012901",
"country_code": "US",
"telephone_number": "815-933-1671",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "600 S Maple St",
"address_purpose": "LOCATION",
"city": "Piper City",
"state": "IL",
"postal_code": "60959",
"country_code": "US",
"telephone_number": "815-686-2277",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "RETTELL",
"first_name": "MIRANDA",
"middle_name": "LEANNE",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-07-03",
"last_updated": "2019-07-03",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "IL",
"license": "160.006575",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "Miranda.rettell@rehabcare.com",
"affiliation": "N",
"address_1": "600 S Maple St",
"city": "Piper City",
"state": "IL",
"country_code": "US",
"postal_code": "609597095",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "Miranda.rettell@rehabecare.com",
"affiliation": "N",
"address_1": "600 S Maple St",
"city": "Piper City",
"state": "IL",
"country_code": "US",
"postal_code": "60959",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Piper City, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.