Active NPI
Patricia L Landgraf, MA, PT
- Pediatric Physical Therapist
- Bloomington, IN
National Provider Identifier
1336351881
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Physical Therapist
- License
- 05005284A
- Practice address
- 2653 S Stratford Dr
Bloomington, IN 47401-4147 - Phone
- (812) 272-1027
- NPI assigned
- May 5, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pediatric Physical Therapist | 2251P0200X | 05005284A | IN | Primary |
Addresses
Primary practice location
2653 S Stratford Dr
Bloomington, IN 47401-4147
Mailing address
2653 S Stratford Dr
Bloomington, IN 47401-4147
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 05005284A | IN | MD | Pediatric Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178323200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1336351881",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2653 S STRATFORD DR",
"city": "BLOOMINGTON",
"state": "IN",
"postal_code": "474014147"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2653 S STRATFORD DR",
"city": "BLOOMINGTON",
"state": "IN",
"postal_code": "474014147",
"telephone_number": "812-272-1027"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LANDGRAF",
"first_name": "PATRICIA",
"middle_name": "L",
"credential": "MA, PT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-05",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2251P0200X",
"taxonomy_group": "",
"desc": "Physical Therapist, Pediatrics",
"state": "IN",
"license": "05005284A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bloomington, IN
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.