Jacob Andrew Sidle, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA013550 Issued in OH

Practice address

2550 S State Route 100
Tiffin, OH 44883-9356

Phone

(419) 447-7203

NPI assigned

Aug 31, 2023

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• P T Services Rehabilitation Inc

  • Occupational Therapy Assistant
  • Tiffin, OH
  • NPI 1003289174
  NPD (past)
• P.T. Services Rehabilitation, Inc.

  • Physical Therapy Clinic/Center
  • Wellington, OH
  • NPI 1972505576
  NPD (past)

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

{
    "created_epoch": "1693440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693440000000",
    "number": "1851176317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "759 HAMPSHIRE CT",
            "city": "AMHERST",
            "state": "OH",
            "postal_code": "440011813",
            "telephone_number": "440-334-6873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2550 S STATE ROUTE 100",
            "city": "TIFFIN",
            "state": "OH",
            "postal_code": "448839356",
            "telephone_number": "419-447-7203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDLE",
        "first_name": "JACOB",
        "middle_name": "ANDREW",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-08-31",
        "last_updated": "2023-08-31",
        "certification_date": "2023-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "OH",
            "license": "PTA013550",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey D Shawberry, DDS
• Wendy Shellhouse
• Tiffany Sherck
• Kaitlin Short, LMSW
• Robert Gordon Shreiner, O.D.
• Chelsae Siebenaler
• Silverado Emergency Physicians, LLC
• Katherine Annette Simmons, LPCC-S
• Kathy Layne Slagle, LPN
• Heather Eileen Sluss

• Physical Therapy Assistant in Tiffin, OH
• Providers in Tiffin, OH by specialty
• Physical Therapy Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2023; 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.