Individual provider Active NPI

Megan Elizabeth Statz, PTA

  • Physical Therapy Assistant
  • Verona, WI
National Provider Identifier
1215104872
Registry record updated Feb 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
1116019 Issued in WI
Practice address
303 S Jefferson St
Verona, WI 53593-1415
Phone
(608) 845-6465
NPI assigned
May 13, 2008
Last updated
Feb 5, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 1116019 WI Primary

Addresses

Primary practice location

303 S Jefferson St
Verona, WI 53593-1415

Mailing address

816 Brookstone CRST
Mount Horeb, WI 53572-3370
Phone (608) 225-4555

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
1116019WIMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1210636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770249600000",
    "number": "1215104872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "816 BROOKSTONE CRST",
            "city": "MOUNT HOREB",
            "state": "WI",
            "postal_code": "535723370",
            "telephone_number": "608-225-4555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 S JEFFERSON ST",
            "city": "VERONA",
            "state": "WI",
            "postal_code": "535931415",
            "telephone_number": "608-845-6465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STATZ",
        "first_name": "MEGAN",
        "middle_name": "ELIZABETH",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-13",
        "last_updated": "2026-02-05",
        "certification_date": "2026-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WI",
            "license": "1116019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Verona, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2026; 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.