Active NPI
Charlotte Anne Strub, PT
- Physical Therapist
- Waterloo, IA
National Provider Identifier
1215980016
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 01016
- Practice address
- 1731 W Ridgeway Ave
Waterloo, IA 50701-4594 - Phone
- (319) 833-5900
- Fax
- (319) 833-5901
- NPI assigned
- May 19, 2006
- 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 Therapist | 225100000X | 01016 | IA | Primary |
Addresses
Primary practice location
1731 W Ridgeway Ave
Waterloo, IA 50701-4594
Mailing address
PO Box 2758
Waterloo, IA 50704-2758
Phone (319) 833-5900
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30999 | Other | IA | WELLMARK INS PLAN |
| 0491753 | Medicaid | IA |
Other names 1
- Charlotte Anne Wahl
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147996800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1191801600000",
"number": "1215980016",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2758",
"city": "WATERLOO",
"state": "IA",
"postal_code": "507042758",
"telephone_number": "319-833-5900",
"fax_number": "319-833-5901"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1731 W RIDGEWAY AVE",
"city": "WATERLOO",
"state": "IA",
"postal_code": "507014594",
"telephone_number": "319-833-5900",
"fax_number": "319-833-5901"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STRUB",
"first_name": "CHARLOTTE",
"middle_name": "ANNE",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-19",
"last_updated": "2007-10-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IA",
"license": "01016",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLMARK INS PLAN",
"identifier": "30999",
"state": "IA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0491753",
"state": "IA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "CHARLOTTE",
"last_name": "WAHL",
"middle_name": "ANNE",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Waterloo, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.