Active NPI
Christopher Tibbs, PTA
- Physical Therapy Assistant
- Eaton, OH
National Provider Identifier
1942562418
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- Practice address
- 501 W Lexington Rd
Eaton, OH 45320-9274 - Phone
- (937) 456-9535
- NPI assigned
- Jun 11, 2012
- Last updated
- Apr 26, 2022
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | PTA009362 | OH | |
| Physical Therapy Assistant | 225200000X | IN | Primary |
Addresses
Primary practice location
501 W Lexington Rd
Eaton, OH 45320-9274
Mailing address
879 Haugesund CV
Eaton, OH 45320-2512
Phone (765) 265-2832
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
| License | State | Type | Specialty |
|---|---|---|---|
| PTA009362 | OH | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1339372800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1650931200000",
"number": "1942562418",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "879 HAUGESUND CV",
"city": "EATON",
"state": "OH",
"postal_code": "453202512",
"telephone_number": "765-265-2832"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "501 W LEXINGTON RD",
"city": "EATON",
"state": "OH",
"postal_code": "453209274",
"telephone_number": "937-456-9535"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TIBBS",
"first_name": "CHRISTOPHER",
"credential": "PTA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-06-11",
"last_updated": "2022-04-26",
"certification_date": "2022-04-26",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "OH",
"license": "PTA009362",
"primary": false
},
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "IN",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Eaton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 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.