Active NPI
Amanda Melanie Lang, LPTA
- Physical Therapy Assistant
- Independence, OH
National Provider Identifier
1689882912
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 5565
- Practice address
- 4511 Rockside Rd Suite #330
Supplemental Health Care
Independence, OH 44132 - Phone
- (216) 901-0400
- Fax
- (216) 901-0401
- NPI assigned
- May 18, 2007
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- No
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 Therapy Assistant | 225200000X | 5565 | OH | Primary |
Addresses
Primary practice location
4511 Rockside Rd Suite #330
Supplemental Health Care
Independence, OH 44132
Mailing address
2168 Bunts Rd
Lakewood, OH 44107
Phone (216) 288-3674
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
| License | State | Type | Specialty |
|---|---|---|---|
| 5565 | OH | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179446400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1689882912",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2168 BUNTS RD",
"city": "LAKEWOOD",
"state": "OH",
"postal_code": "44107",
"telephone_number": "216-288-3674"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4511 ROCKSIDE RD SUITE #330",
"address_2": "SUPPLEMENTAL HEALTH CARE",
"city": "INDEPENDENCE",
"state": "OH",
"postal_code": "44132",
"telephone_number": "216-901-0400",
"fax_number": "216-901-0401"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LANG",
"first_name": "AMANDA",
"middle_name": "MELANIE",
"name_prefix": "Ms.",
"credential": "LPTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-18",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "OH",
"license": "5565",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Independence, OH
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.