Individual provider Active NPI

Christa Marie Stipanovich

  • Physical Therapist
  • Roaring Spring, PA
National Provider Identifier
1457503757
Registry record updated Oct 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT015351 Issued in PA
Practice address
506 Route 36 South
Roaring Spring, PA 16673
Phone
(814) 224-1370
Fax
(814) 224-1371
NPI assigned
Oct 17, 2008
Last updated
Oct 17, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2008

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 PT015351 PA Primary

Addresses

Primary practice location

506 Route 36 South
Roaring Spring, PA 16673

Mailing address

506 Route 36 South
Roaring Spring, PA 16673
Phone (814) 224-1370

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
PT015351PAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Drayer Physical Therapy Institute LLC Physical Therapist Past Accepting new patients
Pro Care Health Systems Inc Past Accepting new patients
Procare PT LP Physical Therapist PastSince Oct 2, 2019 Accepting new patients

Organizations & group practices 3

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": "1224201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224201600000",
    "number": "1457503757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "506 ROUTE 36 SOUTH",
            "city": "ROARING SPRING",
            "state": "PA",
            "postal_code": "16673",
            "telephone_number": "814-224-1370",
            "fax_number": "814-224-1371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 ROUTE 36 SOUTH",
            "city": "ROARING SPRING",
            "state": "PA",
            "postal_code": "16673",
            "telephone_number": "814-224-1370",
            "fax_number": "814-224-1371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STIPANOVICH",
        "first_name": "CHRISTA",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-17",
        "last_updated": "2008-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT015351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roaring Spring, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 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.