Individual provider Active NPI

Lahna Karlyn Robertson

  • Physical Therapy Assistant
  • Cape Girardeau, MO
National Provider Identifier
1912614058
Registry record updated Oct 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
2022041263 Issued in MO
Practice address
3047 William St Ste 100
Cape Girardeau, MO 63703-6569
Phone
(573) 339-5989
NPI assigned
Oct 28, 2022
Last updated
Oct 28, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 28, 2022

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 2022041263 MO Primary

Addresses

Primary practice location

3047 William St Ste 100
Cape Girardeau, MO 63703-6569

Mailing address

3047 William St
Cape Girardeau, MO 63703-6575
Phone (573) 339-5989

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
2022041263MOMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mid America Rehab, P.C. CurrentSince Oct 30, 2022 Accepting new patients

Locations

3047 William St
Cpe Girardeau, MO 63703
Phone (573) 339-5989

3047 William St
Ste 100
Cpe Girardeau, MO 63703
Phone (573) 339-5989

Organizations & group practices 1

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": "1666915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666915200000",
    "number": "1912614058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3047 WILLIAM ST",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637036575",
            "telephone_number": "573-339-5989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3047 WILLIAM ST STE 100",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637036569",
            "telephone_number": "573-339-5989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "LAHNA",
        "middle_name": "KARLYN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-10-28",
        "last_updated": "2022-10-28",
        "certification_date": "2022-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MO",
            "license": "2022041263",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Girardeau, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2022; 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.