Active NPI
Nicole Deann Sleeth, MPT
- Physical Therapist
- Ellenboro, WV
National Provider Identifier
1386657013
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 002367
- Practice address
- 117 West Wagner Street
Ellenboro, WV 26346 - Phone
- (304) 869-3888
- Fax
- (304) 869-3888
- NPI assigned
- Aug 14, 2006
- Last updated
- Aug 28, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 002367 | WV | Primary |
Addresses
Primary practice location
117 West Wagner Street
Ellenboro, WV 26346
Mailing address
415 36TH St Ste 100
Parkersburg, WV 26101-1005
Phone (304) 917-3660
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
| License | State | Type | Specialty |
|---|---|---|---|
| 002367 | WV | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155513600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1535414400000",
"number": "1386657013",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "415 36TH ST STE 100",
"city": "PARKERSBURG",
"state": "WV",
"postal_code": "261011005",
"telephone_number": "304-917-3660",
"fax_number": "304-917-3674"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "117 WEST WAGNER STREET",
"city": "ELLENBORO",
"state": "WV",
"postal_code": "26346",
"telephone_number": "304-869-3888",
"fax_number": "304-869-3888"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SLEETH",
"first_name": "NICOLE",
"middle_name": "DEANN",
"credential": "MPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-14",
"last_updated": "2018-08-28",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WV",
"license": "002367",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ellenboro, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.