Individual provider Active NPI

Emily Marie Wogtech, DPT

  • Physical Therapist
  • Indianapolis, IN
National Provider Identifier
1073808960
Registry record updated Oct 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
05011116A Issued in IN
Practice address
1030 E County Line Rd
Suite A2
Indianapolis, IN 46227-2932
Phone
(317) 887-1121
Fax
(317) 887-1127
NPI assigned
Jun 18, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT26482 FL
Physical Therapist 225100000X 05011116A IN Primary

Addresses

Primary practice location

1030 E County Line Rd
Suite A2
Indianapolis, IN 46227-2932

Mailing address

1030 E County Line Rd
Suite A2
Indianapolis, IN 46227-2932
Phone (317) 887-1121

Other names 1

  • Emily Marie Hall Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230113001999 IN Practitioner - Physical Therapist in Private Practice 6103112776 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Select Physical Therapy Holdings IncGroup PAC ID 9537076401, 1,992 clinicians

Practice addresses (Care Compare)

3316 E Market St
Logansport, IN 46947-2296
Phone (574) 601-3100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT26482FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Select Physical Therapy Holdings Inc CurrentSince Dec 1, 2022 Accepting new patients
Select Physical Therapy Holdings, Inc. Current Accepting new patients
Select Physical Therapy Holdings, Inc. CurrentSince Dec 1, 2022 Accepting new patients
Select Medical Rehabilitation Clinics Inc Past Accepting new patients

Locations

1030 E County Line Rd
Ste A2
Indianapolis, IN 46227
Phone (317) 887-1121

3316 E Market St
Logansport, IN 46947
Phone (574) 601-3100

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1308355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412208000000",
    "number": "1073808960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1030 E COUNTY LINE RD",
            "address_2": "SUITE A2",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462272932",
            "telephone_number": "317-887-1121",
            "fax_number": "317-887-1127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 E COUNTY LINE RD",
            "address_2": "SUITE A2",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462272932",
            "telephone_number": "317-887-1121",
            "fax_number": "317-887-1127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOGTECH",
        "first_name": "EMILY",
        "middle_name": "MARIE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-18",
        "last_updated": "2014-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT26482",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05011116A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EMILY",
            "last_name": "HALL",
            "middle_name": "MARIE",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2014; 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.