Active NPI
Mary Alice Niedenthal, MA, PT, PCS
- Physical Therapist
- Lawrenceburg, IN
National Provider Identifier
1619098191
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 05006847A
- Practice address
- 768 Greentree Rd
Lawrenceburg, IN 47025-7674 - Phone
- (513) 379-2898
- Fax
- (812) 539-4570
- NPI assigned
- Apr 3, 2007
- Sex
- Female
- 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 Therapist | 225100000X | 05006847A | IN | Primary |
Addresses
Primary practice location
768 Greentree Rd
Lawrenceburg, IN 47025-7674
Mailing address
768 Greentree Rd
Lawrenceburg, IN 47025-7674
Phone (513) 379-2898
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)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 05006847A | IN | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175558400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1619098191",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "768 GREENTREE RD",
"city": "LAWRENCEBURG",
"state": "IN",
"postal_code": "470257674",
"telephone_number": "513-379-2898",
"fax_number": "812-539-4570"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "768 GREENTREE RD",
"city": "LAWRENCEBURG",
"state": "IN",
"postal_code": "470257674",
"telephone_number": "513-379-2898",
"fax_number": "812-539-4570"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NIEDENTHAL",
"first_name": "MARY",
"middle_name": "ALICE",
"credential": "MA, PT, PCS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-03",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IN",
"license": "05006847A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lawrenceburg, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.