Individual provider Active NPI

Lauren Cliffton, PTA

  • Physical Therapy Assistant
  • Fort Wayne, IN
National Provider Identifier
1063994341
Registry record updated Sep 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
06005808A Issued in IN
Practice address
5202 Saint Joe Rd
Fort Wayne, IN 46835-3380
Phone
(260) 632-8116
NPI assigned
Sep 3, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X PTA011936 OH
Physical Therapy Assistant 225200000X 06005808A IN Primary

Addresses

Primary practice location

5202 Saint Joe Rd
Fort Wayne, IN 46835-3380

Mailing address

4129 Buesching Dr
Fort Wayne, IN 46815-4807
Phone (419) 630-8830

Other practice location 1

9876 County Road 16
Bryan, OH 43506-9781
Phone (419) 636-4508

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

LicenseStateTypeSpecialty
06005808AINMDPhysical Therapy Assistant
PTA011936OHMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1535932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535932800000",
    "number": "1063994341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4129 BUESCHING DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468154807",
            "telephone_number": "419-630-8830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5202 SAINT JOE RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468353380",
            "telephone_number": "260-632-8116"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9876 County Road 16",
            "address_purpose": "LOCATION",
            "city": "Bryan",
            "state": "OH",
            "postal_code": "435069781",
            "country_code": "US",
            "telephone_number": "419-636-4508",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLIFFTON",
        "first_name": "LAUREN",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-03",
        "last_updated": "2018-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "OH",
            "license": "PTA011936",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IN",
            "license": "06005808A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2018; 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.