Active NPI
Jane Marie Extine, PTA
- Physical Therapy Assistant
- Perrysburg, OH
National Provider Identifier
1083830889
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- PTA.06317
- Practice address
- 28546 Starbright Blvd
Perrysburg, OH 43551-4686 - Phone
- (419) 666-0935
- Fax
- (419) 666-5610
- NPI assigned
- Apr 18, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 | PTA.06317 | OH | Primary |
Addresses
Primary practice location
28546 Starbright Blvd
Perrysburg, OH 43551-4686
Mailing address
1223 Dixie Hwy
Rossford, OH 43460-1405
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 |
|---|---|---|---|
| PTA.06317 | OH | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176854400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1353456000000",
"number": "1083830889",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1223 DIXIE HWY",
"city": "ROSSFORD",
"state": "OH",
"postal_code": "434601405"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "28546 STARBRIGHT BLVD",
"city": "PERRYSBURG",
"state": "OH",
"postal_code": "435514686",
"telephone_number": "419-666-0935",
"fax_number": "419-666-5610"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EXTINE",
"first_name": "JANE",
"middle_name": "MARIE",
"credential": "PTA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-18",
"last_updated": "2012-11-21",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "OH",
"license": "PTA.06317",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Perrysburg, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.