Individual provider Active NPI

Makala Leann Shipley, PTA

  • Physical Therapy Assistant
  • New Lexington, OH
National Provider Identifier
1912587775
Registry record updated Apr 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PTA.012539 Issued in OH
Practice address
3982 Green Rd NE
New Lexington, OH 43764-9117
Phone
(740) 684-1249
NPI assigned
Apr 14, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X PTA.012539 OH Primary

Addresses

Primary practice location

3982 Green Rd NE
New Lexington, OH 43764-9117

Mailing address

7171 Keck Park Cir NW
North Canton, OH 44720-6301
Phone (330) 498-8200

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

LicenseStateTypeSpecialty
PTA.012539OHMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1618358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618358400000",
    "number": "1912587775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7171 KECK PARK CIR NW",
            "city": "NORTH CANTON",
            "state": "OH",
            "postal_code": "447206301",
            "telephone_number": "330-498-8200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3982 GREEN RD NE",
            "city": "NEW LEXINGTON",
            "state": "OH",
            "postal_code": "437649117",
            "telephone_number": "740-684-1249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIPLEY",
        "first_name": "MAKALA",
        "middle_name": "LEANN",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-14",
        "last_updated": "2021-04-14",
        "certification_date": "2021-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "OH",
            "license": "PTA.012539",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Lexington, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2021; 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.