Netherine S Physical Therapy Pelvic Floor and Wellness P C

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

NETHERINE S PHYSICAL THERAPY PELVIC FLOOR AND WELLNESS P C

Practice address

1236 W College Ave
Jacksonville, IL 62650-2215

Phone

(217) 248-9355

Fax

(217) 248-9355

NPI assigned

Mar 29, 2023

Organization subpart

No

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

Authorized official

Name

Netherine Lann Agsalda, PT, DPT, CMTPTNPI 1619302510

Title

Owner

Phone

(217) 248-9355

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Netherine Lann Valencia Agsalda, RPT

  • Physical Therapist
  • White Hall, IL
  • NPI 1619302510
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1680048000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680048000000",
    "number": "1326742669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1236 W COLLEGE AVE",
            "city": "JACKSONVILLE",
            "state": "IL",
            "postal_code": "626502215",
            "telephone_number": "217-248-9355",
            "fax_number": "217-248-9355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1236 W COLLEGE AVE",
            "city": "JACKSONVILLE",
            "state": "IL",
            "postal_code": "626502215",
            "telephone_number": "217-248-9355",
            "fax_number": "217-248-9355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NETHERINE S PHYSICAL THERAPY PELVIC FLOOR AND WELLNESS P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-29",
        "last_updated": "2023-03-29",
        "certification_date": "2023-03-29",
        "status": "A",
        "authorized_official_last_name": "AGSALDA",
        "authorized_official_first_name": "NETHERINE LANN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "217-248-9355",
        "authorized_official_credential": "PT, DPT, CMTPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrea Diane Moore, FNP-BC
• Jennifer Renee Moore, ATC, LMT
• Skyler John Moorman
• Verbal Arthur Morrow, PT
• Laura Jean Naughton, MD
• Luke Norris, DO
• North Church Nursing & Rehab, LLC (Aperion Care Jacksonville)
• North Church Nursing & Rehab, LLC (Aperion Care Jacksonville)
• Northland Hearing Center, Inc.
• Northland Hearing Centers, Inc. (Hearing Health Care Associates)

• Physical Therapist in Jacksonville, IL
• Providers in Jacksonville, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.