Individual provider Active NPI

Nathan Tekavec, MPT

  • Physical Therapist
  • Madison, OH
National Provider Identifier
1295908267
Registry record updated Nov 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070-016336 Issued in IL
Practice address
2583 Walter Green Commons
Madison, OH 44057
Phone
(440) 428-6260
Fax
(440) 428-6276
NPI assigned
Apr 10, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2011

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 070-016336 IL Primary

Addresses

Primary practice location

2583 Walter Green Commons
Madison, OH 44057

Mailing address

2583 Walter Green Commons
Madison, OH 44057
Phone (440) 428-6260

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
070-016336ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Hospital System, Inc PastSince Apr 16, 2013 Accepting new patients
J&K Pain Management Company LLC Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1207785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321228800000",
    "number": "1295908267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2583 WALTER GREEN COMMONS",
            "city": "MADISON",
            "state": "OH",
            "postal_code": "44057",
            "telephone_number": "440-428-6260",
            "fax_number": "440-428-6276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2583 WALTER GREEN COMMONS",
            "city": "MADISON",
            "state": "OH",
            "postal_code": "44057",
            "telephone_number": "440-428-6260",
            "fax_number": "440-428-6276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEKAVEC",
        "first_name": "NATHAN",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-10",
        "last_updated": "2011-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070-016336",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2011; 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.