Individual provider Active NPI

William Homer Jr.

  • Physical Therapist
  • Ligonier, PA
National Provider Identifier
1205386133
Registry record updated Oct 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT011680L Issued in PA
Practice address
117 W Wellington Aly
Ligonier, PA 15658-6201
Phone
(724) 995-8815
NPI assigned
Oct 4, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT011680L PA Primary

Addresses

Primary practice location

117 W Wellington Aly
Ligonier, PA 15658-6201

Mailing address

520 Jefferson Ave
Suite 400
Jeannette, PA 15644-2538
Phone (724) 850-6933

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250331003101 PA Practitioner - Physical Therapist in Private Practice 7012430010 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT011680LPAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Indiana Rehabilitation Services, LLC CurrentSince Feb 7, 2025 Accepting new patients

Organizations & group practices 1

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": "1475539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475539200000",
    "number": "1205386133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 JEFFERSON AVE",
            "address_2": "SUITE 400",
            "city": "JEANNETTE",
            "state": "PA",
            "postal_code": "156442538",
            "telephone_number": "724-850-6933",
            "fax_number": "724-522-4022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 W WELLINGTON ALY",
            "city": "LIGONIER",
            "state": "PA",
            "postal_code": "156586201",
            "telephone_number": "724-995-8815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOMER",
        "first_name": "WILLIAM",
        "name_suffix": "Jr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-10-04",
        "last_updated": "2016-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT011680L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ligonier, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.