Active NPI
Madeline Lieb
- Physical Therapy Assistant
- Fairbanks, AK
National Provider Identifier
1174036321
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- PHYA2771
- Practice address
- 3065 College Rd
Fairbanks, AK 99709-3702 - Phone
- (907) 374-1686
- NPI assigned
- Nov 9, 2017
- Sex
- Female
- Sole proprietor
- No
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 | PHYA2771 | AK | Primary |
Addresses
Primary practice location
3065 College Rd
Fairbanks, AK 99709-3702
Mailing address
3065 College Rd
Fairbanks, AK 99709-3702
Phone (907) 374-1686
Other names 1
- Madeline Liebowitz
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 |
|---|---|---|---|
| PHYA2771 | AK | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1510185600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1510185600000",
"number": "1174036321",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3065 COLLEGE RD",
"city": "FAIRBANKS",
"state": "AK",
"postal_code": "997093702",
"telephone_number": "907-374-1686"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3065 COLLEGE RD",
"city": "FAIRBANKS",
"state": "AK",
"postal_code": "997093702",
"telephone_number": "907-374-1686"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIEB",
"first_name": "MADELINE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-11-09",
"last_updated": "2017-11-09",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "AK",
"license": "PHYA2771",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "MADELINE",
"last_name": "LIEBOWITZ",
"credential": "PTA",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Fairbanks, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.