William Edward Comer – Physical Therapy Assistant

Key facts

NPI: 1689389983
Entity type: Individual (NPI type 1)
Primary specialty: Physical Therapy Assistant 225200000X
Practice address: 304 SW 12TH St
Aledo, IL 61231-2707
Phone: (309) 582-5376
NPI assigned: Jan 20, 2023
Sex: Male
Sole proprietor: Yes

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Physical Therapy Assistant	225200000X			Yes

Addresses

Primary practice location

304 SW 12TH St
Aledo, IL 61231-2707

Mailing address

705 NW 4TH Ave
Galva, IL 61434-1017
Phone (309) 714-8649

Other practice location 1

275 E Carl Sandburg Dr
Galesburg, IL 61401-1249
Phone (309) 344-1151

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jan 20, 2023.

{
    "created_epoch": "1674172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674172800000",
    "number": "1689389983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 NW 4TH AVE",
            "city": "GALVA",
            "state": "IL",
            "postal_code": "614341017",
            "telephone_number": "309-714-8649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 SW 12TH ST",
            "city": "ALEDO",
            "state": "IL",
            "postal_code": "612312707",
            "telephone_number": "309-582-5376"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "275 E Carl Sandburg Dr",
            "address_purpose": "LOCATION",
            "city": "Galesburg",
            "state": "IL",
            "postal_code": "614011249",
            "country_code": "US",
            "telephone_number": "309-344-1151",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COMER",
        "first_name": "WILLIAM",
        "middle_name": "EDWARD",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-01-20",
        "last_updated": "2023-01-20",
        "certification_date": "2023-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aledo, IL

All providers in Aledo, IL · Physical Therapy Assistant in Illinois

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 20, 2023. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.