SGM Physical Therapy

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

SGM PHYSICAL THERAPY

Practice address

410 N 2ND St
Marshall, IL 62441-1010

Phone

(217) 826-2365

NPI assigned

Mar 30, 2007

Last updated

Apr 20, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Steven G Metternich, PTNPI 1134133515

Title

Coowner

Phone

(812) 236-5952

Specialties & licenses 1

Addresses

Other identifiers 5

Other names 1

• Steve Metternich Physical Therapy Former legal business name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Steven Glen Metternich, PT

  • Physical Therapist
  • Terre Haute, IN
  • NPI 1134133515
  NPD (past) Authorized official

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

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1154441244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "513 CONESTOGA CT",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478034218",
            "telephone_number": "812-236-5952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 N 2ND ST",
            "city": "MARSHALL",
            "state": "IL",
            "postal_code": "624411010",
            "telephone_number": "217-826-2365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SGM PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-30",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "METTERNICH",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "COOWNER",
        "authorized_official_telephone_number": "812-236-5952",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS GROUP NPI#",
            "identifier": "1154441244",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "344443227001",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE GROUP",
            "identifier": "DF8520",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP NUMBER",
            "identifier": "0001283001",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DF1743",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Steve Metternich Physical Therapy",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Diana Stanley-Newbold, DIETITIAN

• Physical Therapist in Marshall, IL
• Providers in Marshall, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; 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.