Andrea Stachurski, PT, DPT, CSCS

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

05009003A Issued in IN

Practice address

3519 N Green River Rd
Evansville, IN 47715-1347

Phone

(812) 473-7253

Fax

(812) 473-7264

NPI assigned

Jul 31, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Andrea Martin Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Aegis Group Practice LLC

  • Physical Therapist
  • Indianapolis, IN
  • NPI 1083227169
  NPD
• Aegis Group Practice LLC

  • Physical Therapist
  • Anderson, IN
  • NPI 1386237535
  NPD
• Aegis Group Practice LLC

  • Physical Therapist
  • Indian Harbour Beach, FL
  • NPI 1932072030
  NPD
• Prorehab at Vincennes, LLC

  • Physical Therapy Clinic/Center
  • Vincennes, IN
  • NPI 1750494787

  Physical Therapist

  NPD (past)
• Prorehab Inc

  • Physical Therapist
  • Evansville, IN
  • NPI 1770565509
  NPD (past)

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460937600000",
    "number": "1104832245",
    "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": "630-296-2223",
            "fax_number": "630-759-9510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3519 N GREEN RIVER RD",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477151347",
            "telephone_number": "812-473-7253",
            "fax_number": "812-473-7264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STACHURSKI",
        "first_name": "ANDREA",
        "credential": "PT, DPT, CSCS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-31",
        "last_updated": "2016-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05009003A",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KY",
            "license": "005220",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANDREA",
            "last_name": "MARTIN",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• St. Mary'S Physicians' Health Group, LLC
• Katherine V St. Pere, OTR
• St. Vincent Health Wellness and Preventive Care Institute, Inc.
• Connie Stachowski, RD
• David A Stachowski, OTR
• Karaline Staggs
• Marla Stamm, MSW
• Ian Douglas Stamps, M.D.
• Janice Lynn Stamps, P.T.
• Melissa Ann Stamps, DPT

• Physical Therapist in Evansville, IN
• Providers in Evansville, IN by specialty
• Physical Therapist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 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.

Verify at the official NPI Registry.