Mollye R Leas-Medrek

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT03827 Issued in RI

Practice address

505 Fair St
Warwick, RI 02888-4302

Phone

(812) 662-5033

NPI assigned

Jan 2, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Wild Physical Therapy and Wellness LLC

  • Physical Therapist
  • Pawtucket, RI
  • NPI 1174360176
  NPD Authorized official
• Fox Rehab Ma LLC

  • Physical Therapist
  • Waltham, MA
  • NPI 1497174437
  NPD

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

{
    "created_epoch": "1420156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720915200000",
    "number": "1346638103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 N MAIN ST # 1439",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029045722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 FAIR ST",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028884302",
            "telephone_number": "812-662-5033"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5390 Pershing Ave Apt 505",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631121799",
            "country_code": "US",
            "telephone_number": "812-662-5033",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEAS-MEDREK",
        "first_name": "MOLLYE",
        "middle_name": "R",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-02",
        "last_updated": "2024-07-14",
        "certification_date": "2024-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2014039448",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "RI",
            "license": "PT03827",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Meaghan Elizabeth Layden
• Ashley Le-Pham, MD
• Sylvie Thi Le, PTG
• Debra A Leander
• Allison Leary, PT, DPT
• Thomas Raymond Leddy, MD
• Chang K Lee, M.D.
• Elizabeth Avery Lee, MD
• Jae Gil Lee
• Michael H Lee, MD

• Physical Therapist in Warwick, RI
• Providers in Warwick, RI by specialty
• Physical Therapist in Rhode Island

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