Active NPI
Mariah Devalk, DPT
- Physical Therapist
- Appleton, WI
National Provider Identifier
1194463232
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 15881
- Practice address
- 2500 E Capitol Dr
Appleton, WI 54911-8735 - Phone
- (920) 830-6877
- NPI assigned
- May 26, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 15881 | WI | Primary |
| Physical Therapist | 225100000X |
Addresses
Primary practice location
2500 E Capitol Dr
Appleton, WI 54911-8735
Mailing address
2500 E Capitol Dr
Appleton, WI 54911-8735
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 |
|---|---|---|---|
| 15881 | WI | MD | Physical Therapist |
Interoperability endpoints
- mkratz323053@direct.thedacare.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1653523200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678406400000",
"number": "1194463232",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2500 E CAPITOL DR",
"city": "APPLETON",
"state": "WI",
"postal_code": "549118735"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2500 E CAPITOL DR",
"city": "APPLETON",
"state": "WI",
"postal_code": "549118735",
"telephone_number": "920-830-6877"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEVALK",
"first_name": "MARIAH",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-05-26",
"last_updated": "2023-03-10",
"certification_date": "2023-03-10",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WI",
"license": "15881",
"primary": true
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Appleton, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.