Shelly Kay Fleming, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

02575 Issued in OH

Practice address

1076 Wollenhaupt Dr
Vandalia, OH 45377-3266

Phone

(937) 329-0873

NPI assigned

Oct 31, 2022

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1667174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667174400000",
    "number": "1063129096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1076 WOLLENHAUPT DR",
            "city": "VANDALIA",
            "state": "OH",
            "postal_code": "453773266",
            "telephone_number": "937-329-0873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1076 WOLLENHAUPT DR",
            "city": "VANDALIA",
            "state": "OH",
            "postal_code": "453773266",
            "telephone_number": "937-329-0873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLEMING",
        "first_name": "SHELLY",
        "middle_name": "KAY",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-10-31",
        "last_updated": "2022-10-31",
        "certification_date": "2022-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "OH",
            "license": "02575",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRIVERS LICENSE",
            "identifier": "RT269951",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "bryanfleming68@yahoo.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1076 Wollenhaupt Dr",
            "city": "Vandalia",
            "state": "OH",
            "country_code": "US",
            "postal_code": "453773266",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Obiora Joseph Eziolisa, LPN
• Far Oaks Orthopedists, Inc.
• Sara Ann Farling, NP
• FHS Crossroads, Inc.
• Mark Finton
• Jacqualine Folkerth
• Stephanie Fortner, CDCA
• Myla Fountaine
• Jessica Ann Francisco, APRN-CNP, FNP-C
• Jamie Lee Gable

• Physical Therapy Assistant in Vandalia, OH
• Providers in Vandalia, OH by specialty
• Physical Therapy Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.