Leann Marie Thibo, MS, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AT004522 Issued in OH

Practice address

4687 Wyoga Lake Rd
Stow, OH 44224-1011

Phone

(330) 929-0575

NPI assigned

Feb 2, 2012

Last updated

Nov 14, 2016By the provider in NPPES

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 names 1

• Miss Leann Marie Gilley Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1328140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479081600000",
    "number": "1144592320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2452 THEISS RD",
            "city": "CUYAHOGA FALLS",
            "state": "OH",
            "postal_code": "442233045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4687 WYOGA LAKE RD",
            "city": "STOW",
            "state": "OH",
            "postal_code": "442241011",
            "telephone_number": "330-929-0575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THIBO",
        "first_name": "LEANN",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "MS, ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-02-02",
        "last_updated": "2016-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "OH",
            "license": "AT004522",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LEANN",
            "last_name": "GILLEY",
            "middle_name": "MARIE",
            "prefix": "MISS",
            "credential": "MS, ATC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Athletic Trainer in Stow, OH
• Providers in Stow, OH by specialty
• Athletic Trainer in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2016; 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.