Active NPI
Calissa Martin
- Physical Therapy Assistant
- Hamilton, OH
National Provider Identifier
1255811816
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 10070
- Practice address
- 855 Stahlheber Rd
Hamilton, OH 45013-1963 - Phone
- (513) 844-8004
- NPI assigned
- Aug 14, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 2119099 | TX | |
| Physical Therapy Assistant | 225200000X | 10070 | OH | Primary |
Addresses
Primary practice location
855 Stahlheber Rd
Hamilton, OH 45013-1963
Mailing address
292 Cambridge Dr
Hamilton, OH 45013-2206
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2119099 | Other | TX | PHYSICAL THERAPY ASSISTANT LICENSE |
| 10070 | Other | OH | PHYSICAL THERAPIST ASSISTANT LICENSE |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2119099 | TX | MD | Physical Therapy Assistant |
| 10070 | OH | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1534204800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1634515200000",
"number": "1255811816",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "292 CAMBRIDGE DR",
"city": "HAMILTON",
"state": "OH",
"postal_code": "450132206"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "855 STAHLHEBER RD",
"city": "HAMILTON",
"state": "OH",
"postal_code": "450131963",
"telephone_number": "513-844-8004"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "CALISSA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-08-14",
"last_updated": "2021-10-18",
"certification_date": "2021-10-18",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "TX",
"license": "2119099",
"primary": false
},
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "OH",
"license": "10070",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHYSICAL THERAPY ASSISTANT LICENSE",
"identifier": "2119099",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHYSICAL THERAPIST ASSISTANT LICENSE",
"identifier": "10070",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hamilton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.