Individual provider Active NPI

Sara Ann Zellner, PTA

  • Physical Therapy Assistant
  • Green Bay, WI
National Provider Identifier
1346359064
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
43-019 Issued in WI
Practice address
2100 Riverside Dr
Green Bay, WI 54301-2375
Phone
(920) 433-0111
Fax
(920) 433-8765
NPI assigned
Aug 29, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 43-019 WI Primary

Addresses

Primary practice location

2100 Riverside Dr
Green Bay, WI 54301-2375

Mailing address

PO Box 13508
Green Bay, WI 54307-3508
Phone (920) 433-0111

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

LicenseStateTypeSpecialty
43-019WIMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1346359064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13508",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543073508",
            "telephone_number": "920-433-0111",
            "fax_number": "920-433-8765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 RIVERSIDE DR",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543012375",
            "telephone_number": "920-433-0111",
            "fax_number": "920-433-8765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZELLNER",
        "first_name": "SARA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WI",
            "license": "43-019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Bay, 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.

Verify at the official NPI Registry.