Active NPI
Stephen Douglas Lindley, PTA
- Physical Therapy Assistant
- Advance, NC
National Provider Identifier
1780105635
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 6211
- Practice address
- 142 Bermuda Village Dr BLDG 559
Advance, NC 27006-7867 - Phone
- (336) 940-3557
- NPI assigned
- Jun 30, 2017
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 6211 | NC | Primary |
Addresses
Primary practice location
142 Bermuda Village Dr BLDG 559
Advance, NC 27006-7867
Mailing address
2443 Winterwoods LN Apt 206
Winston Salem, NC 27103-6781
Phone (305) 720-0244
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 |
|---|---|---|---|
| 6211 | NC | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1498780800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1498780800000",
"number": "1780105635",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2443 WINTERWOODS LN APT 206",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271036781",
"telephone_number": "305-720-0244"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "142 BERMUDA VILLAGE DR BLDG 559",
"city": "ADVANCE",
"state": "NC",
"postal_code": "270067867",
"telephone_number": "336-940-3557"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LINDLEY",
"first_name": "STEPHEN",
"middle_name": "DOUGLAS",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-06-30",
"last_updated": "2017-06-30",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "NC",
"license": "6211",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Advance, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.