Leslie Lauren Tanis, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

Practice address

1005 Midwestern Pkwy
Wichita Falls, TX 76302-2211

Phone

(940) 322-0771

NPI assigned

Aug 19, 2021

Last updated

Oct 26, 2023By the provider in NPPES

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

Enrolled in MI

Enrollment records 1

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Center for Physical Rehabilitation and Therapy LP

  • Physical Therapy Clinic/Center
  • Grand Rapids, MI
  • NPI 1902288863

  Physical Therapist

  Medicare reassignment NPD

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

{
    "created_epoch": "1629331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698278400000",
    "number": "1396411203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2216 PEER POINT DR SE",
            "city": "CALEDONIA",
            "state": "MI",
            "postal_code": "493168936",
            "telephone_number": "616-821-5047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 MIDWESTERN PKWY",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763022211",
            "telephone_number": "940-322-0771"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5060 Cascade Rd SE Ste A",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "495463808",
            "country_code": "US",
            "telephone_number": "616-954-0950",
            "fax_number": "616-954-1728",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TANIS",
        "first_name": "LESLIE",
        "middle_name": "LAUREN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-19",
        "last_updated": "2023-10-26",
        "certification_date": "2023-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501303048",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hadia Tahir, M.D.
• Amr Takieldeen, M.D.
• Tom Talbert, M.D.
• Ojus Tamrakar
• Lucy Tan, M.D.
• Abirami Tanjavur, MD
• Gerald Tanner, PTA
• David Randall Tate
• Susan R Tate, MSPT
• Eli Taubert, CRNA

• Physical Therapist in Wichita Falls, TX
• Providers in Wichita Falls, TX by specialty
• Physical Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.