Active NPI
Rebecca H Anderson, MSPT
- Physical Therapist
- Black River Falls, WI
National Provider Identifier
1306903554
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 10588024
- Practice address
- 711 W Adams St
Black River Falls, WI 54615-9108 - Phone
- (715) 284-1330
- Fax
- (715) 284-1398
- NPI assigned
- Jan 3, 2007
- 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 | 10588024 | WI | Primary |
Addresses
Primary practice location
711 W Adams St
Black River Falls, WI 54615-9108
Mailing address
711 W Adams St
Black River Falls, WI 54615-9108
Phone (715) 284-1330
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 10588024 | Other | WI | WISCONSIN LICENSE |
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 |
|---|---|---|---|
| 10588024 | WI | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167782400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1306903554",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "711 W ADAMS ST",
"city": "BLACK RIVER FALLS",
"state": "WI",
"postal_code": "546159108",
"telephone_number": "715-284-1330",
"fax_number": "715-284-1398"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "711 W ADAMS ST",
"city": "BLACK RIVER FALLS",
"state": "WI",
"postal_code": "546159108",
"telephone_number": "715-284-1330",
"fax_number": "715-284-1398"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "REBECCA",
"middle_name": "H",
"credential": "MSPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-03",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WI",
"license": "10588024",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WISCONSIN LICENSE",
"identifier": "10588024",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Black River Falls, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 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.