Individual provider Active NPI

Ethan Samuel Speir, LPTA

  • Physical Therapy Assistant
  • Austin, TX
National Provider Identifier
1639884141
Registry record updated Jan 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
2174178 Issued in TX
Practice address
1917 Lohmans Crossing Rd
Austin, TX 78734-5269
Phone
(512) 261-3211
NPI assigned
Jan 18, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 2174178 TX Primary

Addresses

Primary practice location

1917 Lohmans Crossing Rd
Austin, TX 78734-5269

Mailing address

4507 Topacio Dr
Spicewood, TX 78669-6997
Phone (601) 319-8643

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

State licenses

LicenseStateTypeSpecialty
2174178TXMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1674000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674000000000",
    "number": "1639884141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4507 TOPACIO DR",
            "city": "SPICEWOOD",
            "state": "TX",
            "postal_code": "786696997",
            "telephone_number": "601-319-8643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1917 LOHMANS CROSSING RD",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787345269",
            "telephone_number": "512-261-3211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPEIR",
        "first_name": "ETHAN",
        "middle_name": "SAMUEL",
        "credential": "LPTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-01-18",
        "last_updated": "2023-01-18",
        "certification_date": "2023-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TX",
            "license": "2174178",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

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

Verify at the official NPI Registry.