Individual provider Active NPI

Alfred Leonard Hartick IV, PT

  • Physical Therapist
  • Meadville, PA
National Provider Identifier
1235775651
Registry record updated Nov 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT012963L Issued in PA
Practice address
751 Liberty St
Meadville, PA 16335-2559
Phone
(814) 333-5000
NPI assigned
Nov 20, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2019

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 PT012963L PA Primary

Addresses

Primary practice location

751 Liberty St
Meadville, PA 16335-2559

Mailing address

751 Liberty St
Meadville, PA 16335-2559
Phone (814) 333-5000

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
PT012963LPAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1574208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574208000000",
    "number": "1235775651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "751 LIBERTY ST",
            "city": "MEADVILLE",
            "state": "PA",
            "postal_code": "163352559",
            "telephone_number": "814-333-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "751 LIBERTY ST",
            "city": "MEADVILLE",
            "state": "PA",
            "postal_code": "163352559",
            "telephone_number": "814-333-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARTICK",
        "first_name": "ALFRED",
        "middle_name": "LEONARD",
        "name_suffix": "IV",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-11-20",
        "last_updated": "2019-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT012963L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meadville, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2019; 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.