Active NPI
David Hartman, PTA, LMT
- Massage Therapist
- Boardman, OH
National Provider Identifier
1770940330
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128a(2) exclusion effective Apr 20, 2023.
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 33-021101
- Practice address
- 755 Boardman Canfield Rd
South Bridge West P1
Boardman, OH 44512-4300 - Phone
- (330) 726-7404
- NPI assigned
- Jan 26, 2016
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 33-021101 | OH | Primary |
| Physical Therapy Assistant | 225200000X | 08913 | OH |
Addresses
Primary practice location
755 Boardman Canfield Rd
South Bridge West P1
Boardman, OH 44512-4300
Mailing address
755 Boardman Canfield Rd
South Bridge West P1
Boardman, OH 44512-4300
Phone (330) 726-7404
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
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 08913 | OH | MD | Physical Therapy Assistant |
| 33-021101 | OH | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1453766400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1453852800000",
"number": "1770940330",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "755 BOARDMAN CANFIELD RD",
"address_2": "SOUTH BRIDGE WEST P1",
"city": "BOARDMAN",
"state": "OH",
"postal_code": "445124300",
"telephone_number": "330-726-7404"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "755 BOARDMAN CANFIELD RD",
"address_2": "SOUTH BRIDGE WEST P1",
"city": "BOARDMAN",
"state": "OH",
"postal_code": "445124300",
"telephone_number": "330-726-7404"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARTMAN",
"first_name": "DAVID",
"credential": "PTA, LMT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-01-26",
"last_updated": "2016-01-27",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "OH",
"license": "33-021101",
"primary": true
},
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "OH",
"license": "08913",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boardman, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.