Individual provider Active NPI

Jamie Stuedemann, PTA

  • Physical Therapy Assistant
  • Wausau, WI
National Provider Identifier
1376790980
Registry record updated Aug 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
989-19 Issued in WI
Practice address
1010 E Wausau Ave
Wausau, WI 54403-3101
Phone
(715) 842-2028
NPI assigned
Aug 26, 2008
Sex
Female
Sole proprietor
No

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
989-19WIMDPhysical Therapy Assistant

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 989-19 WI Primary

Addresses

NPPES NPI Registry

Primary practice location

1010 E Wausau Ave
Wausau, WI 54403-3101

Mailing address

1010 E Wausau Ave
Wausau, WI 54403-3101
Phone (715) 842-2028

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 26, 2008.

{
    "created_epoch": "1219708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219708800000",
    "number": "1376790980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 E WAUSAU AVE",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544033101",
            "telephone_number": "715-842-2028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 E WAUSAU AVE",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544033101",
            "telephone_number": "715-842-2028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUEDEMANN",
        "first_name": "JAMIE",
        "name_prefix": "Mrs.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-26",
        "last_updated": "2008-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WI",
            "license": "989-19",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wausau, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2008; 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.