Individual provider Active NPI

Andrew G. Lair, PT, ATC, MED

  • Physical Therapist
  • Cincinnati, OH
National Provider Identifier
1265405609
Registry record updated May 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT05171 Issued in OH
Practice address
9419 Kenwood Rd
Cincinnati, OH 45242-6811
Phone
(513) 792-0777
Fax
(513) 792-0061
NPI assigned
Feb 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 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 PT05171 OH Primary

Addresses

Primary practice location

9419 Kenwood Rd
Cincinnati, OH 45242-6811

Mailing address

9419 Kenwood Rd
Cincinnati, OH 45242-6811
Phone (513) 792-0777

Other identifiers 2

IdentifierTypeStateIssuer
P00611846OtherOHRR MEDICARE PTAN
000000178624OtherOHANTHEM PIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120213000565 OH Practitioner - Physical Therapist in Private Practice 2860392677 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rehabclinics SPT IncGroup PAC ID 7113834102, 101 clinicians

Practice addresses (Care Compare)

9419 Kenwood Rd
Blue Ash, OH 45242-6811
Phone (513) 792-0777

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Education

State licenses

LicenseStateTypeSpecialty
PT05171OHMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Rehabclinics SPT, Inc. CurrentSince Oct 24, 2022 Accepting new patients
Rehabclinics SPT Inc Physical Therapist Current Accepting new patients
Rehabclinics SPT Inc CurrentSince Oct 24, 2022 Accepting new patients
Novacare Rehabilitation of Ohio Inc Past Accepting new patients

Locations

9419 Kenwood Rd
Blue Ash, OH 45242
Phone (513) 227-0703

9596 Colerain Ave
Cincinnati, OH 45251
Phone (513) 661-3114

2475 W Galbraith Rd
Ste A
Cincinnati, OH 45239
Phone (513) 522-0300

Organizations & group practices 23

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1139356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557878400000",
    "number": "1265405609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9419 KENWOOD RD",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452426811",
            "telephone_number": "513-792-0777",
            "fax_number": "513-792-0061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9419 KENWOOD RD",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452426811",
            "telephone_number": "513-792-0777",
            "fax_number": "513-792-0061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAIR",
        "first_name": "ANDREW",
        "middle_name": "G.",
        "name_prefix": "Mr.",
        "credential": "PT, ATC, MED",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-08",
        "last_updated": "2019-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "PT05171",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE PTAN",
            "identifier": "P00611846",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PIN",
            "identifier": "000000178624",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.