1275515512 NPI number — MR. SEAN EDWARD APKE PHYSICAL THERAPY

Table of content: MR. SEAN EDWARD APKE PHYSICAL THERAPY (NPI 1275515512)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1275515512 NPI number — MR. SEAN EDWARD APKE PHYSICAL THERAPY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
APKE
Provider First Name:
SEAN
Provider Middle Name:
EDWARD
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
PHYSICAL THERAPY
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1275515512
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
208 SHADOW WOOD CT
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LOVELAND
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45140-9337
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
513-697-9661
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
625 PROBASCO ST
Provider Second Line Business Practice Location Address:
COMMUNICARE OF CLIFTON
Provider Business Practice Location Address City Name:
CINCINNATI
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45220-2710
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
513-281-2464
Provider Business Practice Location Address Fax Number:
513-281-1309
Provider Enumeration Date:
11/14/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  PT05916 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 38878 . This is a "ANTHEM" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 2549693 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".




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