Individual provider Active NPI

Ann Lynn Bobalik, PT

  • Geriatric Physical Therapist
  • Wellsville, OH
National Provider Identifier
1508435405
Registry record updated Jun 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Physical TherapistTaxonomy code 2251G0304X
License
4530 Issued in OH
Practice address
1015 Riverside Ave Apt B
Wellsville, OH 43968-1385
Phone
(304) 374-3795
NPI assigned
Jun 23, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Physical Therapist 2251G0304X 4530 OH Primary

Addresses

Primary practice location

1015 Riverside Ave Apt B
Wellsville, OH 43968-1385

Mailing address

1015 Riverside Ave Apt B
Wellsville, OH 43968-1385
Phone (304) 374-3795

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

LicenseStateTypeSpecialty
4530OHMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1624406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624406400000",
    "number": "1508435405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 RIVERSIDE AVE APT B",
            "city": "WELLSVILLE",
            "state": "OH",
            "postal_code": "439681385",
            "telephone_number": "304-374-3795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 RIVERSIDE AVE APT B",
            "city": "WELLSVILLE",
            "state": "OH",
            "postal_code": "439681385",
            "telephone_number": "304-374-3795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOBALIK",
        "first_name": "ANN",
        "middle_name": "LYNN",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-23",
        "last_updated": "2021-06-23",
        "certification_date": "2021-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251G0304X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Geriatrics",
            "state": "OH",
            "license": "4530",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wellsville, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2021; 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.