Active NPI
Gina Menke
- Pediatric Physical Therapist
- Tiffin, OH
National Provider Identifier
1013463512
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Physical Therapist
- License
- 016206
- Practice address
- 27 St Lawrence Dr Ste 104TH
Tiffin, OH 44883-8312 - Phone
- (419) 604-0649
- NPI assigned
- Aug 25, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Physical Therapist | 2251P0200X | 016206 | OH | Primary |
Addresses
Primary practice location
27 St Lawrence Dr Ste 104TH
Tiffin, OH 44883-8312
Mailing address
741 N Hall St
Ottawa, OH 45875-1448
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 |
|---|---|---|---|
| 016206 | OH | MD | Pediatric Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1472083200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1472083200000",
"number": "1013463512",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "741 N HALL ST",
"city": "OTTAWA",
"state": "OH",
"postal_code": "458751448"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "27 ST LAWRENCE DR STE 104TH",
"city": "TIFFIN",
"state": "OH",
"postal_code": "448838312",
"telephone_number": "419-604-0649"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MENKE",
"first_name": "GINA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-08-25",
"last_updated": "2016-08-25",
"status": "A"
},
"taxonomies": [
{
"code": "2251P0200X",
"taxonomy_group": "",
"desc": "Physical Therapist, Pediatrics",
"state": "OH",
"license": "016206",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tiffin, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.