Individual provider Active NPI

Savannah Gean Axley, PTA

  • Physical Therapy Assistant
  • New Harmony, IN
National Provider Identifier
1386890580
Registry record updated Feb 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
06003296A Issued in IN
Practice address
251 State Road 66
New Harmony, IN 47631
Phone
(812) 682-4104
NPI assigned
Aug 7, 2008
Last updated
Feb 17, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 160.004789 IL
Physical Therapy Assistant 225200000X 06003296A IN Primary

Addresses

Primary practice location

251 State Road 66
New Harmony, IN 47631

Mailing address

1011 Pinehurst Dr
Mount Vernon, IN 47620-8218
Phone (812) 838-6770

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
160.004789ILMDPhysical Therapy Assistant
06003296AINMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1218067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329436800000",
    "number": "1386890580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 PINEHURST DR",
            "city": "MOUNT VERNON",
            "state": "IN",
            "postal_code": "476208218",
            "telephone_number": "812-838-6770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "251 STATE ROAD 66",
            "city": "NEW HARMONY",
            "state": "IN",
            "postal_code": "47631",
            "telephone_number": "812-682-4104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AXLEY",
        "first_name": "SAVANNAH",
        "middle_name": "GEAN",
        "name_prefix": "Mrs.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-07",
        "last_updated": "2012-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IL",
            "license": "160.004789",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IN",
            "license": "06003296A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Harmony, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2012; 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.