Individual provider Active NPI

Andrew Somers

  • Physical Therapy Assistant
  • Naperville, IL
National Provider Identifier
1255975504
Registry record updated Oct 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
160008800 Issued in IL
Practice address
1935 Springbrook Square Dr
Naperville, IL 60564-5947
Phone
(630) 637-9955
NPI assigned
Oct 30, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2019

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 160008800 IL Primary

Addresses

Primary practice location

1935 Springbrook Square Dr
Naperville, IL 60564-5947

Mailing address

30W281 Small Tree CT
Warrenville, IL 60555-1343
Phone (630) 551-5241

Other practice location 1

7416 S County Line Rd
Burr Ridge, IL 60527-7960
Phone (630) 601-6192

Other identifiers 1

IdentifierTypeStateIssuer
16000880OtherILPTA LICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL WebPT

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
160008800ILMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1572393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572393600000",
    "number": "1255975504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30W281 SMALL TREE CT",
            "city": "WARRENVILLE",
            "state": "IL",
            "postal_code": "605551343",
            "telephone_number": "630-551-5241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1935 SPRINGBROOK SQUARE DR",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605645947",
            "telephone_number": "630-637-9955"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7416 S County Line Rd",
            "address_purpose": "LOCATION",
            "city": "Burr Ridge",
            "state": "IL",
            "postal_code": "605277960",
            "country_code": "US",
            "telephone_number": "630-601-6192",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SOMERS",
        "first_name": "ANDREW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-10-30",
        "last_updated": "2019-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IL",
            "license": "160008800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTA LICENSE",
            "identifier": "16000880",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "WebPT",
            "affiliation": "N",
            "address_1": "1935 Springbrook Square Dr",
            "city": "Naperville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605645947",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 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.