NPIMap

Organization Active NPI

Leading Edge, Inc

  • Physical Therapist
  • Papillion, NE
National Provider Identifier
1730344201
Registry record updated Dec 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
LEADING EDGE, INC
Practice address
11336 S 96TH St
Suite 114
Papillion, NE 68046-4286
Phone
(402) 315-3603
Fax
(402) 315-3604
NPI assigned
Jul 24, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2024

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

Authorized official

Name
Michael D Bartels
Title
President
Phone
(402) 315-3603

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

11336 S 96TH St
Suite 114
Papillion, NE 68046-4286

Mailing address

11336 S 96TH St
Suite 114
Papillion, NE 68046-4286
Phone (402) 315-3603

Other identifiers 1

IdentifierTypeStateIssuer
10025656400MedicaidNE

Other names 1

  • Edge Physical Therapy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080909000476 NE Part B Supplier - Physical/Occupational Therapy Group in Private Practice 5496821894 Receives reassigned benefits from 4 practitioners
Practice locations: Papillion, NE

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1216857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733184000000",
    "number": "1730344201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11336 S 96TH ST",
            "address_2": "SUITE 114",
            "city": "PAPILLION",
            "state": "NE",
            "postal_code": "680464286",
            "telephone_number": "402-315-3603",
            "fax_number": "402-315-3604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11336 S 96TH ST",
            "address_2": "SUITE 114",
            "city": "PAPILLION",
            "state": "NE",
            "postal_code": "680464286",
            "telephone_number": "402-315-3603",
            "fax_number": "402-315-3604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEADING EDGE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-24",
        "last_updated": "2024-12-03",
        "certification_date": "2024-12-03",
        "status": "A",
        "authorized_official_last_name": "BARTELS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "402-315-3603"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025656400",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Edge Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Papillion, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.