Theron C Statler, PTA, LMT

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA-06680 Issued in OH

Practice address

4400 Airway Rd
Dayton, OH 45431-1330

Phone

(937) 241-5837

NPI assigned

Jan 14, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1200268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219708800000",
    "number": "1235315839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4400 AIRWAY RD",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454311330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 AIRWAY RD",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454311330",
            "telephone_number": "937-241-5837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STATLER",
        "first_name": "THERON",
        "middle_name": "C",
        "credential": "PTA, LMT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-01-14",
        "last_updated": "2008-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "OH",
            "license": "PTA-06680",
            "primary": true
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OH",
            "license": "LMT 33.011673",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• State of Ohio Department of Mental Health
• Camela Robin Staten, INDEPENDENT PROVIDER
• Jasmine Staten
• Mary Elizabeth Staten
• Tashawna Staten, LPN
• Taylor Staudt, DPM
• Thomas Stauffer, CDCA
• Regina Fern Staup, MS, APN, ACNP-BC
• Samantha Rose Stautberg, MS, RDN, LD
• Stay at Home Healthcare, Co.

• Physical Therapy Assistant in Dayton, OH
• Providers in Dayton, OH by specialty
• Physical Therapy Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2008; 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.