Individual provider Active NPI

Stephanie Anne Gehlhausen, MSPT

  • Specialist
  • La Porte, IN
National Provider Identifier
1174729552
Registry record updated Aug 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
05008187A Issued in IN
Practice address
1007 Lincolnway
La Porte, IN 46350-3201
Phone
(219) 326-2391
NPI assigned
Jun 22, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 13, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 05008187A IN Primary

Addresses

Primary practice location

1007 Lincolnway
La Porte, IN 46350-3201

Mailing address

55614 Cardinal Dr
South Bend, IN 46619-4601
Phone (574) 386-7972

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
05008187AINMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1182470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407888000000",
    "number": "1174729552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55614 CARDINAL DR",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466194601",
            "telephone_number": "574-386-7972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1007 LINCOLNWAY",
            "city": "LA PORTE",
            "state": "IN",
            "postal_code": "463503201",
            "telephone_number": "219-326-2391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEHLHAUSEN",
        "first_name": "STEPHANIE",
        "middle_name": "ANNE",
        "name_prefix": "Mrs.",
        "credential": "MSPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-22",
        "last_updated": "2014-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "IN",
            "license": "05008187A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Porte, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2014; 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.