Patricia S Maetzold, OTRL PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2220 Issued in MN

Practice address

3915 Golden Valley Road
Courage Center
Golden Valley, MN 55422-4298

Phone

(763) 520-0494

Fax

(763) 520-0355

NPI assigned

Jul 22, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Patricia S Dewaard Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1153526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393372800000",
    "number": "1356362628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3915 GOLDEN VALLEY ROAD",
            "address_2": "COURAGE CENTER",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554224298",
            "telephone_number": "763-520-0494",
            "fax_number": "763-520-0355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3915 GOLDEN VALLEY ROAD",
            "address_2": "COURAGE CENTER",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554224298",
            "telephone_number": "763-520-0494",
            "fax_number": "763-520-0355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAETZOLD",
        "first_name": "PATRICIA",
        "middle_name": "S",
        "credential": "OTRL  PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-22",
        "last_updated": "2014-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MN",
            "license": "103328",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IA",
            "license": "01566",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "2220",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PATRICIA",
            "last_name": "DEWAARD",
            "middle_name": "S",
            "credential": "OTRL PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Malinda Lynch, FNP, PMHNP
• Lynda Richtsmeier Cyr, PH.D., L.P., LLC
• John Thomas Macdonald, M.D.
• Bruce James Mack, M.D.
• Ian Roderick Macpherson, ATC, LAT
• Alice Frances Maguire, COTA
• Samira S. Mahabadi, DDS
• Rebecca Ann Malooly, MSW, LICSW
• Mamey Care LLC
• Angela M Mann, OTR/L

• Physical Therapist in Golden Valley, MN
• Providers in Golden Valley, MN by specialty
• Physical Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2014; 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.