Betty Marie Spear, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

104019 Issued in WI

Practice address

2801 S Webster Ave
Green Bay, WI 54301-2878

Phone

(920) 403-7665

Fax

(920) 337-1126

NPI assigned

Apr 19, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1013134105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 S WEBSTER AVE",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543012878",
            "telephone_number": "920-403-7665",
            "fax_number": "920-337-1126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 S WEBSTER AVE",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543012878",
            "telephone_number": "920-403-7665",
            "fax_number": "920-337-1126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPEAR",
        "first_name": "BETTY",
        "middle_name": "MARIE",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WI",
            "license": "104019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Courtney S Sowers, LPC
• Space Coast Family Practice
• Nicole Lee Spaeth, APNP
• Jacob P Spangenberg, CSAC
• Nicole Spangenberg
• Spectrum Behavioral Health LLC
• Kristen Spees, MS, OT
• Alaina Marie Sperber, D.C.
• Tricia Lynn Spice, RN
• Beth Spicer, OTR

• Physical Therapy Assistant in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Physical Therapy Assistant in Wisconsin

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.