Active NPI
Wanda Elaine Pierce
- Physical Therapy Assistant
- Chardon, OH
National Provider Identifier
1326378084
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 04179
- Practice address
- 620 Water Street
Chardon Health Care
Chardon, OH 44024 - Phone
- (440) 285-9400
- NPI assigned
- Dec 31, 2009
- 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 | 04179 | OH | Primary |
Addresses
Primary practice location
620 Water Street
Chardon Health Care
Chardon, OH 44024
Mailing address
883 Long Shadow LN
Roaming Shores, OH 44085-9764
Phone (440) 563-5507
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 |
|---|---|---|---|
| 04179 | OH | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1262217600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1262217600000",
"number": "1326378084",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "883 LONG SHADOW LN",
"city": "ROAMING SHORES",
"state": "OH",
"postal_code": "440859764",
"telephone_number": "440-563-5507"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "620 WATER STREET",
"address_2": "CHARDON HEALTH CARE",
"city": "CHARDON",
"state": "OH",
"postal_code": "44024",
"telephone_number": "440-285-9400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PIERCE",
"first_name": "WANDA",
"middle_name": "ELAINE",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-12-31",
"last_updated": "2009-12-31",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "OH",
"license": "04179",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chardon, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.