Individual provider Active NPI

Lacey Ann Cline, MPT

  • Physical Therapist
  • Weirton, WV
National Provider Identifier
1861554933
Registry record updated Apr 20, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
002590 Issued in WV
Practice address
414 Penco Rd
Weirton, WV 26062-3822
Phone
(304) 723-3780
NPI assigned
Dec 15, 2006
Last updated
Apr 20, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 002590 WV Primary

Addresses

Primary practice location

414 Penco Rd
Weirton, WV 26062-3822

Mailing address

414 Penco Rd
Weirton, WV 26062-3822
Phone (304) 723-3780

Other names 1

  • Ms. Lacey Ann Cashdollar Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070103000330 WV Practitioner - Physical Therapist in Private Practice 2365442084 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

414 Penco Rd
Weirton, WV 26062-3822

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
002590WVMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Physical Therapy Limited Partnership CurrentSince Sep 1, 2022 Accepting new patients
Summit Physical Therapy Limited Partnership Physical Therapist CurrentSince Sep 1, 2022 Accepting new patients
Preston Rehabilitation & Orthopedic Physical Therapy, Inc Physical Therapist PastSince Jan 1, 2004 Accepting new patients

Locations

118 Carolina Ave
Chester, WV 26034
Phone (304) 387-0409

1425 Main St
Follansbee, WV 26037
Phone (304) 527-4472

621 N Chester St
New Cumberlnd, WV 26047
Phone (304) 564-1098

414 Penco Rd
Weirton, WV 26062
Phone (304) 723-3780

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240185600000",
    "number": "1861554933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "414 PENCO RD",
            "city": "WEIRTON",
            "state": "WV",
            "postal_code": "260623822",
            "telephone_number": "304-723-3780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "414 PENCO RD",
            "city": "WEIRTON",
            "state": "WV",
            "postal_code": "260623822",
            "telephone_number": "304-723-3780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLINE",
        "first_name": "LACEY",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-15",
        "last_updated": "2009-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WV",
            "license": "002590",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LACEY",
            "last_name": "CASHDOLLAR",
            "middle_name": "ANN",
            "prefix": "MS.",
            "credential": "MPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Weirton, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.