Individual provider Active NPI

Leigh Ann Meismer Vidrine, PT

  • Physical Therapist
  • Schulenburg, TX
National Provider Identifier
1982817797
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1089043 Issued in TX
Practice address
205 E Avenue, Suite B
Schulenburg, TX 78956
Phone
(979) 743-4109
NPI assigned
May 8, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 1089043 TX Primary

Addresses

Primary practice location

205 E Avenue, Suite B
Schulenburg, TX 78956

Mailing address

PO Box 30
Hallettsville, TX 77964
Phone (361) 798-4116

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150702002154 MD Practitioner - Physical Therapist in Private Practice 1355372814 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3179 Braverton St
Suite 201
Edgewater, MD 21037-2667
Phone (410) 956-4308

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1089043TXMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Vidrine Integrative Physical Therapy Physical Therapist Current Accepting new patients
Bayside Physical Therapy & Sports Rehabilitation Limited Partnership Physical Therapist CurrentSince Dec 24, 2019 Accepting new patients
Oak Manor, Inc. Past Accepting new patients

Locations

202 Coursevall Dr
Ste 111
Centreville, MD 21617
Phone (410) 758-0018

3179 Braverton St
Ste 201
Edgewater, MD 21037
Phone (410) 956-4308

7671 Quarterfield Rd
Ste 101
Glen Burnie, MD 21061
Phone (410) 590-2334

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": "1178582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1982817797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30",
            "city": "HALLETTSVILLE",
            "state": "TX",
            "postal_code": "77964",
            "telephone_number": "361-798-4116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 E AVENUE, SUITE B",
            "city": "SCHULENBURG",
            "state": "TX",
            "postal_code": "78956",
            "telephone_number": "979-743-4109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIDRINE",
        "first_name": "LEIGH ANN",
        "middle_name": "MEISMER",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1089043",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Schulenburg, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.