Larissa Ann Gerhartz, P.T.A

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

842 Issued in NE

Practice address

600 W 12TH St
Imperial, NE 69033-3130

Phone

(308) 882-7111

NPI assigned

Aug 23, 2011

Sex

Female

Sole proprietor

No

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, last updated by the provider on Aug 23, 2011.

{
    "created_epoch": "1314057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314057600000",
    "number": "1497035307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 819",
            "city": "IMPERIAL",
            "state": "NE",
            "postal_code": "690330819",
            "telephone_number": "308-882-7111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 W 12TH ST",
            "city": "IMPERIAL",
            "state": "NE",
            "postal_code": "690333130",
            "telephone_number": "308-882-7111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERHARTZ",
        "first_name": "LARISSA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "P.T.A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-23",
        "last_updated": "2011-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NE",
            "license": "842",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Imperial, NE
• Physical Therapy Assistant in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2011; 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.