Active NPI
Megan Rose Gasperich, PTA
- Physical Therapy Assistant
- Depere, WI
National Provider Identifier
1386977155
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 1551-019
- Practice address
- 200 S. 9TH St.
Depere, WI 54115 - Phone
- (920) 338-4146
- NPI assigned
- Sep 11, 2009
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 1551-019 | WI | Primary |
Addresses
Primary practice location
200 S. 9TH St.
Depere, WI 54115
Mailing address
1450 Silverstone Trail
Apt. 9
Depere, WI 54115
Phone (920) 819-1611
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1551-019 | WI | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1252627200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1252627200000",
"number": "1386977155",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1450 SILVERSTONE TRAIL",
"address_2": "APT. 9",
"city": "DEPERE",
"state": "WI",
"postal_code": "54115",
"telephone_number": "920-819-1611"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 S. 9TH ST.",
"city": "DEPERE",
"state": "WI",
"postal_code": "54115",
"telephone_number": "920-338-4146"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GASPERICH",
"first_name": "MEGAN",
"middle_name": "ROSE",
"name_prefix": "Mrs.",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-09-11",
"last_updated": "2009-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "WI",
"license": "1551-019",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Depere, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.