Individual provider Active NPI

Laura Wassilak, DPT

  • Physical Therapist
  • Chesterton, IN
National Provider Identifier
1134565484
Registry record updated May 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
05009358A Issued in IN
Practice address
1120 S Calumet Rd
Suite 3
Chesterton, IN 46304-3285
Phone
(219) 983-9675
Fax
(219) 983-9681
NPI assigned
May 14, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 05009358A IN Primary

Addresses

Primary practice location

1120 S Calumet Rd
Suite 3
Chesterton, IN 46304-3285

Mailing address

102 Somerset Dr
Valparaiso, IN 46383-2478
Phone (219) 477-6943

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

LicenseStateTypeSpecialty
05009358AINMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1368489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1368489600000",
    "number": "1134565484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 SOMERSET DR",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463832478",
            "telephone_number": "219-477-6943",
            "fax_number": "219-983-9681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 S CALUMET RD",
            "address_2": "SUITE 3",
            "city": "CHESTERTON",
            "state": "IN",
            "postal_code": "463043285",
            "telephone_number": "219-983-9675",
            "fax_number": "219-983-9681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASSILAK",
        "first_name": "LAURA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-14",
        "last_updated": "2013-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05009358A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesterton, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2013; 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.