Active NPI
Meagan Kathleen Ipema
- Physical Therapist
- Merrillville, IN
National Provider Identifier
1104479716
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 05009995A
- Practice address
- 8455 Broadway
Merrillville, IN 46410-6220 - Phone
- (219) 769-7211
- Fax
- (219) 769-7236
- NPI assigned
- Jul 23, 2019
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 05009995A | IN | Primary |
Addresses
Primary practice location
8455 Broadway
Merrillville, IN 46410-6220
Mailing address
790 Remington Blvd
Bolingbrook, IL 60440-4909
Phone (630) 296-2222
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 05009995A | IN | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1563840000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1563840000000",
"number": "1104479716",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "790 REMINGTON BLVD",
"city": "BOLINGBROOK",
"state": "IL",
"postal_code": "604404909",
"telephone_number": "630-296-2222",
"fax_number": "630-759-9510"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8455 BROADWAY",
"city": "MERRILLVILLE",
"state": "IN",
"postal_code": "464106220",
"telephone_number": "219-769-7211",
"fax_number": "219-769-7236"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IPEMA",
"first_name": "MEAGAN",
"middle_name": "KATHLEEN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-07-23",
"last_updated": "2019-07-23",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IN",
"license": "05009995A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Merrillville, IN
- Integrity Home Health of Lake County Inc
- Integrity Home Health of Northwest Indiana Inc.
- Internal Medicine Associates
- Internal Medicine Center of NW Indiana, PC (Advanced Rehabilitation Services)
- Interventional Clinics of America LLC
- Irehab Therapeutic Specialists, LLC (iRehab Therapeutic Specialists)
- Samantha Irk, RBT
- Nunya Irvine, DMD
- Isaac I-Care, LLC (The Region's Vision Center)
- Wayne M Isailovich, LAC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.