Andrea Kae Fitzgerald, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

1296019 Issued in WI

Practice address

482 Oak St
Berlin, WI 54923-1204

Phone

(920) 361-5832

Fax

(920) 361-5870

NPI assigned

Apr 14, 2008

Last updated

Oct 3, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Miss Andrea Kae Ernst Former name

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": "1208131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475452800000",
    "number": "1114191848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2759",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549122759",
            "telephone_number": "920-830-5900",
            "fax_number": "920-830-5910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "482 OAK ST",
            "city": "BERLIN",
            "state": "WI",
            "postal_code": "549231204",
            "telephone_number": "920-361-5832",
            "fax_number": "920-361-5870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITZGERALD",
        "first_name": "ANDREA",
        "middle_name": "KAE",
        "name_prefix": "Mrs.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-14",
        "last_updated": "2016-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WI",
            "license": "1296019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANDREA",
            "last_name": "ERNST",
            "middle_name": "KAE",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Evergreen Home of Berlin, Inc.
• Evergreen Pines Inc
• Jason Lee Fairweather, LPC, SACIT, CSIT
• Field Pharmacy LLC
• Benjamin Field, DPH
• Jason Flynn, PHARMD
• Fox River Dental Associates SC
• Fox Valley Hematology & Oncology, S.C.
• Julie R Fredrick, APNP
• Garner Anesthesia Services LLC

• Physical Therapy Assistant in Berlin, WI
• Providers in Berlin, 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 Oct 3, 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.