Pam Redfearn, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

05006286A Issued in IN

Practice address

1005 N Hickory Rd
South Bend, IN 46615-3723

Phone

(574) 233-5754

Fax

(574) 233-7406

NPI assigned

Oct 2, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• McDonald Physical Therapy and Sports Rehabilitation Center

  • Physical Therapy Assistant
  • South Bend, IN
  • NPI 1710863691
  NPD

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1417040718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10",
            "city": "GRANGER",
            "state": "IN",
            "postal_code": "465300010",
            "telephone_number": "574-247-9489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 N HICKORY RD",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466153723",
            "telephone_number": "574-233-5754",
            "fax_number": "574-233-7406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDFEARN",
        "first_name": "PAM",
        "name_prefix": "Mrs.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05006286A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "000000176392",
            "identifier": "ANTHEM",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andrew Redding
• Antoinette Redding, BSW, MS, MSW, LMHC
• Christina Reddy, D.O
• Deepak Reddy, M.D.
• Jagadeesh Reddy, M.D.
• Kendall Redman, MSW, LSW
• Sarah Elizabeth Redman, ATC
• John L Reed, M.D.
• Matthew Russell Reed, MD
• Michael Owen Reed, PH.D.

• Physical Therapist in South Bend, IN
• Providers in South Bend, IN by specialty
• Physical Therapist in Indiana

• 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.