Individual provider Active NPI

Joanna Mastalerz

  • Physical Therapist
  • Columbia, TN
National Provider Identifier
1376917914
Registry record updated Nov 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2232 Issued in TN
Practice address
1810 Shady Brook St
Suite 3
Columbia, TN 38401-3993
Phone
(931) 388-8500
NPI assigned
Nov 19, 2015
Last updated
Nov 19, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2232 TN Primary

Addresses

Primary practice location

1810 Shady Brook St
Suite 3
Columbia, TN 38401-3993

Mailing address

1810 Shady Brook St
Suite 3
Columbia, TN 38401-3993

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
2232TNMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Physical Therapy, LLC Physical Therapist Past Accepting new patients
Independent Physical Therapy LLC Physical Therapist Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1447891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447891200000",
    "number": "1376917914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1810 SHADY BROOK ST",
            "address_2": "SUITE 3",
            "city": "COLUMBIA",
            "state": "TN",
            "postal_code": "384013993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1810 SHADY BROOK ST",
            "address_2": "SUITE 3",
            "city": "COLUMBIA",
            "state": "TN",
            "postal_code": "384013993",
            "telephone_number": "931-388-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASTALERZ",
        "first_name": "JOANNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-19",
        "last_updated": "2015-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "2232",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2015; 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.