1447374632 NPI number — LEIGH ANNE ROBERTS D.P.T, O.C.S.

NPI Number: 1447374632
Health Care Provider/Practitioner: LEIGH ANNE ROBERTS D.P.T, O.C.S.

NPI Number : 1447374632 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1447374632",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "ROBERTS",
    "FirstName": "LEIGH",
    "MiddleName": "ANNE",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "D.P.T, O.C.S.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "6201 GREENLEIGH AVE",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "BALTIMORE",
    "MailingAddressStateName": "MD",
    "MailingAddressPostalCode": "21220-2004",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "410-933-6423",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "1 E MOUNT VERNON PL",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "BALTIMORE",
    "PracticeLocationAddressStateName": "MD",
    "PracticeLocationAddressPostalCode": "21202-2308",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "443-997-5476",
    "PracticeLocationAddressFaxNumber": "410-847-3838",
    "EnumerationDate": "03/16/2007",
    "LastUpdateDate": "01/14/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "2251X0800X",
          "TaxonomyName": "Orthopedic Physical Therapist",
          "LicenseNumber": "19791",
          "LicenseNumberStateCode": "MD",
          "PrimaryTaxonomySwitch": "Y"
        },
        {
          "TaxonomyCode": "225100000X",
          "TaxonomyName": "Physical Therapist",
          "LicenseNumber": "19791",
          "LicenseNumberStateCode": "MD",
          "PrimaryTaxonomySwitch": "N"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}