NPIMap

Individual provider Active NPI

Herman L Colley III

  • Physical Therapy Assistant
  • Lucasville, OH
National Provider Identifier
1184963589
Registry record updated Feb 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
06837 Issued in OH
Practice address
10098A Big Bearcreek Rd
Lucasville, OH 45648-8622
Phone
(740) 259-2351
NPI assigned
Feb 5, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 5, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 06837 OH Primary

Addresses

Primary practice location

10098A Big Bearcreek Rd
Lucasville, OH 45648-8622

Mailing address

10098A Bearcreek Rd
Lucasville, OH 45648-8622
Phone (740) 259-2351

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

LicenseStateTypeSpecialty
06837OHMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lucasville II Facility Operations, LLC Past Accepting new patients
Tandem Health Care of Lucasville II, Inc. 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.

NPI Registry JSON

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

{
    "created_epoch": "1360022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360022400000",
    "number": "1184963589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10098A BEARCREEK RD",
            "city": "LUCASVILLE",
            "state": "OH",
            "postal_code": "456488622",
            "telephone_number": "740-259-2351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10098A BIG BEARCREEK RD",
            "city": "LUCASVILLE",
            "state": "OH",
            "postal_code": "456488622",
            "telephone_number": "740-259-2351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLEY",
        "first_name": "HERMAN",
        "middle_name": "L",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-02-05",
        "last_updated": "2013-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "OH",
            "license": "06837",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lucasville, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2013; 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.