Individual provider Active NPI

Ronda L Wangerin, P.T.

  • Physical Therapist
  • Deer Lodge, MT
National Provider Identifier
1487716734
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
100PT Issued in MT
Practice address
310 Main St
Deer Lodge, MT 59722-1057
Phone
(406) 846-3448
Fax
(406) 846-2298
NPI assigned
Dec 14, 2006
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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 100PT MT Primary

Addresses

Primary practice location

310 Main St
Deer Lodge, MT 59722-1057

Mailing address

310 Main St
Deer Lodge, MT 59722-1057
Phone (406) 846-3448

Other identifiers 1

IdentifierTypeStateIssuer
3401229MedicaidMT

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
100MTMDNaturopath
100PTMTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Peaklife Rehab and Wellness, PLLC Physical Therapist CurrentSince Feb 14, 2021 Accepting new patients
Deer Lodge Valley Therapy PastSince May 22, 2010 Accepting new patients
Center for Physical Therapy & Wellness Inc PastSince Oct 16, 2006 Accepting new patients

Locations

307 Missouri Ave
Deer Lodge, MT 59722
Phone (406) 846-3448

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": "1166054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1487716734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 MAIN ST",
            "city": "DEER LODGE",
            "state": "MT",
            "postal_code": "597221057",
            "telephone_number": "406-846-3448",
            "fax_number": "406-846-2298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 MAIN ST",
            "city": "DEER LODGE",
            "state": "MT",
            "postal_code": "597221057",
            "telephone_number": "406-846-3448",
            "fax_number": "406-846-2298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANGERIN",
        "first_name": "RONDA",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-14",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MT",
            "license": "100PT",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3401229",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Deer Lodge, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.