Active NPI
Caleb Lionberger, PTA, ATC
- Physical Therapy Assistant
- Peoria, AZ
National Provider Identifier
1265679807
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 7528A
- Practice address
- 8685 W Union Hills Dr
Peoria, AZ 85382-7006 - Phone
- (623) 486-2331
- NPI assigned
- Jan 20, 2009
- Sex
- Male
- 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 | 7528A | AZ | Primary |
| Athletic Trainer | 2255A2300X | 1137 | AZ |
Addresses
Primary practice location
8685 W Union Hills Dr
Peoria, AZ 85382-7006
Mailing address
5188 W Campo Bello Dr
Glendale, AZ 85308-3925
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 |
|---|---|---|---|
| 7528A | AZ | MD | Physical Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| SLK Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Specialist
- Peoria, AZ
- NPI 1245266451
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1232409600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1435190400000",
"number": "1265679807",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5188 W CAMPO BELLO DR",
"city": "GLENDALE",
"state": "AZ",
"postal_code": "853083925"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8685 W UNION HILLS DR",
"city": "PEORIA",
"state": "AZ",
"postal_code": "853827006",
"telephone_number": "623-486-2331"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIONBERGER",
"first_name": "CALEB",
"credential": "PTA, ATC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-01-20",
"last_updated": "2015-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "AZ",
"license": "7528A",
"primary": true
},
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "AZ",
"license": "1137",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Peoria, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.