Individual provider Active NPI

Jana Leigh Richmond, PTA

  • Physical Therapy Assistant
  • Gibson City, IL
National Provider Identifier
1245457753
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
Practice address
10 Doctors Park
Gibson City, IL 60936-2009
Phone
(217) 784-2650
Fax
(217) 784-8023
NPI assigned
Apr 19, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 IL Primary

Addresses

Primary practice location

10 Doctors Park
Gibson City, IL 60936-2009

Mailing address

1206 S Fawn Dr
Mahomet, IL 61853-3647
Phone (217) 784-2650

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
160-000675ILMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245457753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1206 S FAWN DR",
            "city": "MAHOMET",
            "state": "IL",
            "postal_code": "618533647",
            "telephone_number": "217-784-2650",
            "fax_number": "217-784-8023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 DOCTORS PARK",
            "city": "GIBSON CITY",
            "state": "IL",
            "postal_code": "609362009",
            "telephone_number": "217-784-2650",
            "fax_number": "217-784-8023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHMOND",
        "first_name": "JANA",
        "middle_name": "LEIGH",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gibson City, IL

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.

Verify at the official NPI Registry.