Active NPI
Rebecca Goellner
- Physical Therapy Assistant
- Van Nuys, CA
National Provider Identifier
1306349824
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- PTA48988
- Practice address
- 16300 Roscoe Blvd
Van Nuys, CA 91406-1258 - Phone
- (818) 893-4426
- NPI assigned
- Mar 11, 2018
- 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 | PTA48988 | CA | Primary |
Addresses
Primary practice location
16300 Roscoe Blvd
Van Nuys, CA 91406-1258
Mailing address
6618 County Road 318
Palmyra, MO 63461-2108
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 |
|---|---|---|---|
| PTA48988 | CA | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1520726400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1520726400000",
"number": "1306349824",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6618 COUNTY ROAD 318",
"city": "PALMYRA",
"state": "MO",
"postal_code": "634612108"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16300 ROSCOE BLVD",
"city": "VAN NUYS",
"state": "CA",
"postal_code": "914061258",
"telephone_number": "818-893-4426"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOELLNER",
"first_name": "REBECCA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-03-11",
"last_updated": "2018-03-11",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "CA",
"license": "PTA48988",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Van Nuys, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.