Active NPI
Leah J Terry, PTA, CMT
- Physical Therapy Assistant
- Bloomington, IN
National Provider Identifier
1750671145
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 06002501A
- Practice address
- 3211 E Moores Pike
Bloomington, IN 47401-7129 - Phone
- (812) 334-7604
- Fax
- (812) 334-7705
- NPI assigned
- Apr 19, 2011
- Last updated
- Apr 17, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 06002501A | IN | Primary |
| Massage Therapist | 225700000X | MT20900843 | IN |
Addresses
Primary practice location
3211 E Moores Pike
Bloomington, IN 47401-7129
Mailing address
10747 US Highway 50 W
Bedford, IN 47421-8331
Phone (812) 279-3320
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 |
|---|---|---|---|
| 06002501A | IN | MD | Physical Therapy Assistant |
| MT20900843 | IN | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Legacy Healthcare Services Inc | Past | Accepting new patients | |
| Legacy Healthcare Services, Inc. | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Physical Therapist
- Kokomo, IN
- NPI 1518069913
-
- Physical Therapist
- Cary, NC
- NPI 1225879489
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1303171200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1334620800000",
"number": "1750671145",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10747 US HIGHWAY 50 W",
"city": "BEDFORD",
"state": "IN",
"postal_code": "474218331",
"telephone_number": "812-279-3320"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3211 E MOORES PIKE",
"city": "BLOOMINGTON",
"state": "IN",
"postal_code": "474017129",
"telephone_number": "812-334-7604",
"fax_number": "812-334-7705"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TERRY",
"first_name": "LEAH",
"middle_name": "J",
"name_prefix": "Mrs.",
"credential": "PTA, CMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-04-19",
"last_updated": "2012-04-17",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "IN",
"license": "06002501A",
"primary": true
},
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "IN",
"license": "MT20900843",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Bloomington, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.