Michaela Marie Mahaffey, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

092077 Issued in IA

Practice address

514 17TH St W
Clear Lake, IA 50428-1205

Phone

(706) 564-3558

NPI assigned

Sep 26, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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": "1537920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537920000000",
    "number": "1093290983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "514 17TH ST W",
            "city": "CLEAR LAKE",
            "state": "IA",
            "postal_code": "504281205",
            "telephone_number": "706-564-3558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "514 17TH ST W",
            "city": "CLEAR LAKE",
            "state": "IA",
            "postal_code": "504281205",
            "telephone_number": "706-564-3558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHAFFEY",
        "first_name": "MICHAELA",
        "middle_name": "MARIE",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-26",
        "last_updated": "2018-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MN",
            "license": "A2377",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IA",
            "license": "092077",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Britta Ann Lee, PHARMD
• Lehmann Family Dental PLLC
• Grant Lehmann, DDS
• Julie Livingston, RN
• Amanda Nicole Long
• Mark J Scribbins
• Craig Donald Markham, BA
• Martinek Physical Therapy, P.L.C.
• Ronald Gerald Martinek, P.T.
• Taylor May, MD

• Physical Therapy Assistant in Clear Lake, IA
• Providers in Clear Lake, IA by specialty
• Physical Therapy Assistant in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 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.