Individual provider Active NPI

Theresa Lynn Tretter, P.T.

  • Physical Therapist
  • Huntingburg, IN
National Provider Identifier
1508903469
Registry record updated Jul 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
05002187A Issued in IN
Practice address
307 N Main St
Huntingburg, IN 47542-1344
Phone
(812) 683-5555
Fax
(812) 683-1111
NPI assigned
Jan 31, 2007
Last updated
Jul 16, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2024

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 05002187A IN Primary

Addresses

Primary practice location

307 N Main St
Huntingburg, IN 47542-1344

Mailing address

307 N Main St
P.O. Box 225
Huntingburg, IN 47542-1344
Phone (812) 683-5555

Other identifiers 1

IdentifierTypeStateIssuer
200871210 AMedicaidIN

Other names 1

  • Theresa Lynn Tretter-Jahn Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070516000339 IN Practitioner - Physical Therapist in Private Practice 6103923735 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
05002187AINMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Tretter Physical Therapy PC Physical Therapist CurrentSince Apr 1, 2007 Accepting new patients

Locations

307 N Main St
Huntingburg, IN 47542
Phone (812) 683-5555

Organizations & group practices 1

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": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721088000000",
    "number": "1508903469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 N MAIN ST",
            "address_2": "P.O. BOX 225",
            "city": "HUNTINGBURG",
            "state": "IN",
            "postal_code": "475421344",
            "telephone_number": "812-683-5555",
            "fax_number": "812-683-1111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 N MAIN ST",
            "city": "HUNTINGBURG",
            "state": "IN",
            "postal_code": "475421344",
            "telephone_number": "812-683-5555",
            "fax_number": "812-683-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRETTER",
        "first_name": "THERESA",
        "middle_name": "LYNN",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-31",
        "last_updated": "2024-07-16",
        "certification_date": "2024-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05002187A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200871210 A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "THERESA",
            "last_name": "TRETTER-JAHN",
            "middle_name": "LYNN",
            "credential": "PT, DPT",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Huntingburg, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.