Active NPI
Ernest E, Petite, CPTA
- Physical Therapy Assistant
- Lansing, KS
National Provider Identifier
1174738017
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 14-01353
- Practice address
- 730 1St Ter
Lansing, KS 66043-1704 - Phone
- (913) 727-1755
- NPI assigned
- May 14, 2007
- Sex
- Male
- 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 | 14-01353 | KS | Primary |
Addresses
Primary practice location
730 1St Ter
Lansing, KS 66043-1704
Mailing address
16536 Hildebrandt Rd
Leavenworth, KS 66048-8465
Phone (913) 758-1881
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 |
|---|---|---|---|
| 14-01353 | KS | MD | Physical Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Leavenworth Unified School 453 | Past | Accepting new patients | |
| Leavenworth County Special Education Cooperative | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Local Education Agency (LEA)
- Lansing, KS
- NPI 1821213711
-
- Student Health Clinic/Center
- Lansing, KS
- NPI 1346373941
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179100800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1174738017",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16536 HILDEBRANDT RD",
"city": "LEAVENWORTH",
"state": "KS",
"postal_code": "660488465",
"telephone_number": "913-758-1881"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "730 1ST TER",
"city": "LANSING",
"state": "KS",
"postal_code": "660431704",
"telephone_number": "913-727-1755"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETITE",
"first_name": "ERNEST",
"middle_name": "E,",
"name_prefix": "Mr.",
"credential": "CPTA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "KS",
"license": "14-01353",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Lansing, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.