Gwen Ann McClure, LPTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

1037-019 Issued in WI

Practice address

481 Oaklawn Ave
481 Oaklawn Avenue
Green Bay, WI 54304-4929

Phone

(920) 433-0533

NPI assigned

Apr 8, 2008

Last updated

Apr 8, 2008By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1207612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207612800000",
    "number": "1477726842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "481 OAKLAWN AVE",
            "address_2": "481 OAKLAWN AVENUE",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543044929",
            "telephone_number": "920-433-0533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "481 OAKLAWN AVE",
            "address_2": "481 OAKLAWN AVENUE",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543044929",
            "telephone_number": "920-433-0533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLURE",
        "first_name": "GWEN",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "LPTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-08",
        "last_updated": "2008-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WI",
            "license": "1037-019",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40211400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sirena J MC Mahon, DNP
• Kristin M McCabe, P.A.
• Melissa G McCadden, APNP
• Connor McCarthy
• Abigail Sarah McClellan
• Brooke Erin McComb, N.P.
• Glenda Ann McConnell, PMHNP, BC
• Jacob L McCormick, CCC-SLP
• Jeremy Boone McCue, MD
• Dawn P McCullough, APNP

• Physical Therapy Assistant in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Physical Therapy Assistant in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 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.