Active NPI
Ashlei L Moses
- Physical Therapy Assistant
- Lebanon, IL
National Provider Identifier
1114130135
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 160.004743
- Practice address
- 1 Perryman St
Lebanon, IL 62254-1356 - Phone
- (618) 537-6165
- NPI assigned
- May 7, 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 | 160.004743 | IL | Primary |
Addresses
Primary practice location
1 Perryman St
Lebanon, IL 62254-1356
Mailing address
108 Ridge Dr
Maryville, IL 62062-5681
Phone (618) 402-9204
Other names 1
- Ashlei L Kopec
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 |
|---|---|---|---|
| 160.004743 | IL | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178496000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1249689600000",
"number": "1114130135",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "108 RIDGE DR",
"city": "MARYVILLE",
"state": "IL",
"postal_code": "620625681",
"telephone_number": "618-402-9204"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 PERRYMAN ST",
"city": "LEBANON",
"state": "IL",
"postal_code": "622541356",
"telephone_number": "618-537-6165"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOSES",
"first_name": "ASHLEI",
"middle_name": "L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-07",
"last_updated": "2009-08-08",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "IL",
"license": "160.004743",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "ASHLEI",
"last_name": "KOPEC",
"middle_name": "L",
"code": "2",
"type": "Professional Name"
}
]
}
Other providers in Lebanon, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.