Individual provider Active NPI

David James Lanphere Jr., PTA

  • Physical Therapy Assistant
  • Lancaster, NY
National Provider Identifier
1750021408
Registry record updated Mar 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
012649-01 Issued in NY
Practice address
8 Fernwood Dr
Lancaster, NY 14086-4458
Phone
(716) 489-0841
NPI assigned
Mar 30, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 30, 2022

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 012649-01 NY Primary

Addresses

Primary practice location

8 Fernwood Dr
Lancaster, NY 14086-4458

Mailing address

8 Fernwood Dr
Lancaster, NY 14086-4458
Phone (716) 489-0841

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
012649-01NYMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1648598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648598400000",
    "number": "1750021408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 FERNWOOD DR",
            "city": "LANCASTER",
            "state": "NY",
            "postal_code": "140864458",
            "telephone_number": "716-489-0841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 FERNWOOD DR",
            "city": "LANCASTER",
            "state": "NY",
            "postal_code": "140864458",
            "telephone_number": "716-489-0841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANPHERE",
        "first_name": "DAVID",
        "middle_name": "JAMES",
        "name_suffix": "Jr.",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-03-30",
        "last_updated": "2022-03-30",
        "certification_date": "2022-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NY",
            "license": "012649-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2022; 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.