Individual provider Active NPI

Steven A. Leathers, PTA

  • Physical Therapy Assistant
  • Bryan, OH
National Provider Identifier
1770754095
Registry record updated Mar 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PTA2514 Issued in OH
Practice address
442 W High St
Bryan, OH 43506-1681
Phone
(419) 636-4517
Fax
(419) 636-6438
NPI assigned
Mar 14, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2008

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 PTA2514 OH Primary

Addresses

Primary practice location

442 W High St
Bryan, OH 43506-1681

Mailing address

442 W High St
Bryan, OH 43506-1681
Phone (419) 636-4517

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
PTA2514OHMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1205452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205452800000",
    "number": "1770754095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "442 W HIGH ST",
            "city": "BRYAN",
            "state": "OH",
            "postal_code": "435061681",
            "telephone_number": "419-636-4517",
            "fax_number": "419-636-6438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "442 W HIGH ST",
            "city": "BRYAN",
            "state": "OH",
            "postal_code": "435061681",
            "telephone_number": "419-636-4517",
            "fax_number": "419-636-6438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEATHERS",
        "first_name": "STEVEN",
        "middle_name": "A.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-03-14",
        "last_updated": "2008-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "OH",
            "license": "PTA2514",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bryan, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2008; 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.