Individual provider Active NPI

Michael Leroy Carter

  • Physical Therapy Assistant
  • Cleveland, OH
National Provider Identifier
1649639386
Registry record updated Feb 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
08244 Issued in OH
Practice address
14900 Private Dr
Cleveland, OH 44112-3470
Phone
(216) 851-4268
NPI assigned
Feb 22, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 22, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 08244 OH Primary
Physical Therapy Assistant 225200000X 2118822 TX

Addresses

Primary practice location

14900 Private Dr
Cleveland, OH 44112-3470

Mailing address

101 E State St
Kennett Square, PA 19348-3109
Phone (800) 243-4556

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
08244OHMDPhysical Therapy Assistant
2118822TXMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1456099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456099200000",
    "number": "1649639386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 E STATE ST",
            "city": "KENNETT SQUARE",
            "state": "PA",
            "postal_code": "193483109",
            "telephone_number": "800-243-4556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14900 PRIVATE DR",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441123470",
            "telephone_number": "216-851-4268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARTER",
        "first_name": "MICHAEL",
        "middle_name": "LEROY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-02-22",
        "last_updated": "2016-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "OH",
            "license": "08244",
            "primary": true
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TX",
            "license": "2118822",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2016; 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.