Individual provider Active NPI

Leah Rae Ontko, LPN

  • Licensed Practical Nurse
  • Parkersburg, WV
National Provider Identifier
1306682117
Registry record updated Jul 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
41353 Issued in WV
Practice address
425 Juliana St
Parkersburg, WV 26101-5352
Phone
(304) 893-9777
NPI assigned
Jul 2, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 41353 WV Primary

Addresses

Primary practice location

425 Juliana St
Parkersburg, WV 26101-5352

Mailing address

3004 9TH Ave
Vienna, WV 26105-2422

Other names 1

  • Miss Leah Rae Truax Former name

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
41353WVMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Clean & Clear Advantage, LLC CurrentSince Jul 7, 2024 Accepting new patients
Clean and Clear Advantage CurrentSince Jul 7, 2024 Accepting new patients

Locations

425 Juliana St
Parkersburg, WV 26101
Phone (304) 689-4334

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": "1719878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719878400000",
    "number": "1306682117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3004 9TH AVE",
            "city": "VIENNA",
            "state": "WV",
            "postal_code": "261052422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 JULIANA ST",
            "city": "PARKERSBURG",
            "state": "WV",
            "postal_code": "261015352",
            "telephone_number": "304-893-9777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ONTKO",
        "first_name": "LEAH",
        "middle_name": "RAE",
        "name_prefix": "Ms.",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-02",
        "last_updated": "2024-07-02",
        "certification_date": "2024-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "WV",
            "license": "41353",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LEAH",
            "last_name": "TRUAX",
            "middle_name": "RAE",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Parkersburg, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2024; 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.