Individual provider Active NPI

Sandra Lee Zach, PTA

  • Physical Therapy Assistant
  • Fremont, NE
National Provider Identifier
1437420932
Registry record updated Jan 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
169 Issued in NE
Practice address
655 W 23Rd St
Fremont, NE 68025-2595
Phone
(402) 753-6130
NPI assigned
Jan 16, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 169 NE Primary

Addresses

Primary practice location

655 W 23Rd St
Fremont, NE 68025-2595

Mailing address

3056 S 35TH Ave
Omaha, NE 68105-3555
Phone (402) 699-3461

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
169NEMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1326672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326672000000",
    "number": "1437420932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3056 S 35TH AVE",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681053555",
            "telephone_number": "402-699-3461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 W 23RD ST",
            "city": "FREMONT",
            "state": "NE",
            "postal_code": "680252595",
            "telephone_number": "402-753-6130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZACH",
        "first_name": "SANDRA",
        "middle_name": "LEE",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-16",
        "last_updated": "2012-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NE",
            "license": "169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fremont, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2012; 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.