Kraig William Leiby, PTA

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

PT008902L Issued in PA

Practice address

1350 Broadcasting Rd
Ste 201
Wyomissing, PA 19610-3220

Phone

(610) 685-9600

Fax

(610) 685-6700

NPI assigned

Aug 30, 2005

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1125360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219708800000",
    "number": "1497748933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1350 BROADCASTING RD",
            "address_2": "STE 201",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196103220",
            "telephone_number": "610-685-9600",
            "fax_number": "610-685-6700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 BROADCASTING RD",
            "address_2": "STE 201",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196103220",
            "telephone_number": "610-685-9600",
            "fax_number": "610-685-6700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEIBY",
        "first_name": "KRAIG",
        "middle_name": "WILLIAM",
        "name_prefix": "Mr.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-30",
        "last_updated": "2008-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "PA",
            "license": "PT008902L",
            "primary": true
        },
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "PA",
            "license": "PT008902L",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel B Lee
• Taylor Wixon Ford Lee, CRNP
• Young Hawke Lee, D.D.S.
• Elizabeth M Lefever
• Amanda S Legge, O.D.
• Martine Lennon, LPC
• Leonard J Marchinski MD PC
• Leonard J Marchinski, MD PC
• Jeffrey Joseph Leoni, PSY.D.
• Joseph V Leoni, M.D.

• Physical Medicine & Rehabilitation Physician in Wyomissing, PA
• Providers in Wyomissing, PA by specialty
• Physical Medicine & Rehabilitation Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2008; 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.