Active NPI
Jeffery Lee Stein, ATC, DPT
- Physical Therapist
- West Lafayette, IN
National Provider Identifier
1457327207
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 05007539A
- Practice address
- 355 N Martin Jischke Dr
Wellness Suite - PT
West Lafayette, IN 47907-2030 - Phone
- (765) 494-1839
- Fax
- (765) 496-0079
- NPI assigned
- Feb 23, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 05007539A | IN | Primary |
| Athletic Trainer | 2255A2300X | 3600945A | IN | |
| Physical Therapist | 225100000X | 070-019026 | IL |
Addresses
Primary practice location
355 N Martin Jischke Dr
Wellness Suite - PT
West Lafayette, IN 47907-2030
Mailing address
355 N Martin Jischke Dr
Wellness Suite - PT
West Lafayette, IN 47907-2030
Phone (765) 494-1839
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 36000945A | Other | IN | AT LICENSE |
| 05007539A | Other | IN | PT LICENSE |
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 |
|---|---|---|---|
| 070-019026 | IL | MD | Physical Therapist |
| 05007539A | IN | MD | Physical Therapist |
| 3600945A | IN | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140652800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1434499200000",
"number": "1457327207",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "355 N MARTIN JISCHKE DR",
"address_2": "WELLNESS SUITE - PT",
"city": "WEST LAFAYETTE",
"state": "IN",
"postal_code": "479072030",
"telephone_number": "765-494-1839",
"fax_number": "765-496-0079"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "355 N MARTIN JISCHKE DR",
"address_2": "WELLNESS SUITE - PT",
"city": "WEST LAFAYETTE",
"state": "IN",
"postal_code": "479072030",
"telephone_number": "765-494-1839",
"fax_number": "765-496-0079"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEIN",
"first_name": "JEFFERY",
"middle_name": "LEE",
"credential": "ATC, DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-23",
"last_updated": "2015-06-17",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IN",
"license": "05007539A",
"primary": true
},
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "IN",
"license": "3600945A",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "070-019026",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AT LICENSE",
"identifier": "36000945A",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PT LICENSE",
"identifier": "05007539A",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in West Lafayette, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.