Active NPI
John W Niemeyer, PTA
- Physical Therapy Assistant
- Louisville, KY
National Provider Identifier
1427836717
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 010365
- Practice address
- 2701 Chestnut Station CT
Louisville, KY 40299-6395 - Phone
- (800) 335-1060
- NPI assigned
- Sep 18, 2023
- Sex
- Male
- Sole proprietor
- Yes
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 Therapy Assistant | 225200000X | 010365 | OH | Primary |
Addresses
Primary practice location
2701 Chestnut Station CT
Louisville, KY 40299-6395
Mailing address
5861 Melody LN
Mentor on the Lake, OH 44060-3135
Phone (440) 321-5755
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 |
|---|---|---|---|
| 010365 | OH | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1694995200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1694995200000",
"number": "1427836717",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5861 MELODY LN",
"city": "MENTOR ON THE LAKE",
"state": "OH",
"postal_code": "440603135",
"telephone_number": "440-321-5755"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2701 CHESTNUT STATION CT",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402996395",
"telephone_number": "800-335-1060"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NIEMEYER",
"first_name": "JOHN",
"middle_name": "W",
"credential": "PTA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-09-18",
"last_updated": "2023-09-18",
"certification_date": "2023-09-18",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "OH",
"license": "010365",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Louisville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.