Active NPI
Rachel Nicole Sundberg, PTA
- Physical Therapy Assistant
- Central City, NE
National Provider Identifier
1124624408
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 1910
- Practice address
- 2720 17TH Ave
Central City, NE 68826-9614 - Phone
- (308) 946-3088
- NPI assigned
- Dec 10, 2020
- Last updated
- Dec 10, 2020
- 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 |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 1910 | NE | Primary |
Addresses
Primary practice location
2720 17TH Ave
Central City, NE 68826-9614
Mailing address
2720 17TH Ave
Central City, NE 68826-9614
Phone (308) 946-3088
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 |
|---|---|---|---|
| 1910 | NE | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1607558400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1607558400000",
"number": "1124624408",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2720 17TH AVE",
"city": "CENTRAL CITY",
"state": "NE",
"postal_code": "688269614",
"telephone_number": "308-946-3088"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2720 17TH AVE",
"city": "CENTRAL CITY",
"state": "NE",
"postal_code": "688269614",
"telephone_number": "308-946-3088"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUNDBERG",
"first_name": "RACHEL",
"middle_name": "NICOLE",
"credential": "PTA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-12-10",
"last_updated": "2020-12-10",
"certification_date": "2020-12-10",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "NE",
"license": "1910",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Central City, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.