Stephanie A Weyrauch, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT-10022 Issued in MN

Practice address

1511 Highway 59 S
Suite a
Thief River Falls, MN 56701-3413

Phone

(218) 681-0449

Fax

(218) 681-0490

NPI assigned

Jun 18, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Stephanie A Sandvick Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1434585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440547200000",
    "number": "1255712972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1560 S CAROL ST",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836461839",
            "telephone_number": "208-287-9420",
            "fax_number": "208-287-9426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1511 HIGHWAY 59 S",
            "address_2": "SUITE A",
            "city": "THIEF RIVER FALLS",
            "state": "MN",
            "postal_code": "567013413",
            "telephone_number": "218-681-0449",
            "fax_number": "218-681-0490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEYRAUCH",
        "first_name": "STEPHANIE",
        "middle_name": "A",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-18",
        "last_updated": "2015-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "PT-10022",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MN LICENSE",
            "identifier": "PT-10022",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "SANDVICK",
            "middle_name": "A",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Physical Therapist in Thief River Falls, MN
• Providers in Thief River Falls, MN by specialty
• Physical Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2015; 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.