Active NPI
Catherine M Stumpf
- Physical Therapy Assistant
- Jerseyville, IL
National Provider Identifier
1205444916
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 160008712
- Practice address
- 1251 N State St
Jerseyville, IL 62052-1169 - Phone
- (618) 498-6441
- NPI assigned
- Jul 20, 2020
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 160008712 | IL | Primary |
Addresses
Primary practice location
1251 N State St
Jerseyville, IL 62052-1169
Mailing address
326 N Main Street
Carrollton, IL 62016
Phone (217) 942-9596
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2020 | Medicaid | IL |
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 |
|---|---|---|---|
| 160008712 | IL | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1595203200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1595203200000",
"number": "1205444916",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "326 N MAIN STREET",
"city": "CARROLLTON",
"state": "IL",
"postal_code": "62016",
"telephone_number": "217-942-9596"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1251 N STATE ST",
"city": "JERSEYVILLE",
"state": "IL",
"postal_code": "620521169",
"telephone_number": "618-498-6441"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STUMPF",
"first_name": "CATHERINE",
"middle_name": "M",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-07-20",
"last_updated": "2020-07-20",
"certification_date": "2020-07-20",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "IL",
"license": "160008712",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2020",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Jerseyville, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 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.