Christopher Michael Ifantiedes, AT, ATC, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT018660 Issued in OH

Practice address

2955 E State St Ste 5
Salem, OH 44460-9307

Phone

(234) 575-0174

Fax

(234) 575-0177

NPI assigned

Oct 28, 2014

Sex

Male

Sole proprietor

No

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

Enrolled in OH

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Drayer Physical Therapy Northern Ohio LLC

  • Physical Therapist
  • Dayton, OH
  • NPI 1871919969
  Medicare reassignment NPD

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

{
    "created_epoch": "1414454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593561600000",
    "number": "1871998252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 CORPORATE DR STE 400",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352425424",
            "telephone_number": "423-541-5492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2955 E STATE ST STE 5",
            "city": "SALEM",
            "state": "OH",
            "postal_code": "444609307",
            "telephone_number": "234-575-0174",
            "fax_number": "234-575-0177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IFANTIEDES",
        "first_name": "CHRISTOPHER",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "AT, ATC, PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-10-28",
        "last_updated": "2020-07-01",
        "certification_date": "2020-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "PT018660",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa J. Hopkins, P.A
• Sara Houchins
• Devan Taylor Houshour, PTA
• Austen Hutton, DPT
• Melinda L Hutton
• Dale Lynne Iler
• Nicholas Inchak
• J H Lease Drug Co
• J H Lease Drug Co
• Charles Jackson, QMHS-H

• Physical Therapist in Salem, OH
• Providers in Salem, OH by specialty
• Physical Therapist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.