NPIMap

Individual provider Active NPI

Molly Ann Stevens, DPT

  • Physical Therapist
  • Mentor, OH
National Provider Identifier
1154572691
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
10642 Issued in OH
Practice address
8500 Station St # 255
Mentor, OH 44060-4943
Phone
(440) 725-0703
NPI assigned
Oct 2, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 05009602A IN
Physical Therapist 225100000X 10642 OH Primary

Addresses

Primary practice location

8500 Station St # 255
Mentor, OH 44060-4943

Mailing address

8500 Station St # 255
Mentor, OH 44060-4943
Phone (440) 725-0703

Other practice location 1

3740 Edison Lakes Pkwy
Mishawaka, IN 46545-3474
Phone (574) 252-4150

Other identifiers 1

IdentifierTypeStateIssuer
000000611574OtherINANTHEM BC/BS

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
6900SCMDProfessional Counselor
05009602AINMDPhysical Therapist
10642OHMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Michiana Spine, Sports & Occupational Rehab, PC Past Accepting new patients
Michiana Spine, Sports & Occupational Rehab, PC Past Accepting new patients
Physio Therapy Solutions LLC Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1222905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1154572691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8500 STATION ST # 255",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440604943",
            "telephone_number": "440-725-0703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8500 STATION ST # 255",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440604943",
            "telephone_number": "440-725-0703"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3740 Edison Lakes Pkwy",
            "address_purpose": "LOCATION",
            "city": "Mishawaka",
            "state": "IN",
            "postal_code": "465453474",
            "country_code": "US",
            "telephone_number": "574-252-4150",
            "fax_number": "574-252-4159",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STEVENS",
        "first_name": "MOLLY",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-02",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05009602A",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "10642",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC/BS",
            "identifier": "000000611574",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mentor, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 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.