Carli J. Obermeyer, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

028475 Issued in NY

Practice address

61 Emerald PL
Rock Hill, NY 12775-6049

Phone

(845) 703-6999

Fax

(845) 703-6297

NPI assigned

Jan 22, 2008

Last updated

Oct 12, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Ms. Carli J. Vanwagenen Other name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Northern Physical Therapy, LLC

  • Physical Therapist
  • Ogdensburg, NY
  • NPI 1174624969
  Medicare reassignment NPD
• Northern Physical Therapy, PLLC

  • Physical Therapy Clinic/Center
  • Ogdensburg, NY
  • NPI 1609297746
  NPD (past)

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

{
    "created_epoch": "1200960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602460800000",
    "number": "1639356561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 CRYSTAL RUN RD",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109414057",
            "telephone_number": "845-703-6999",
            "fax_number": "845-703-6297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61 EMERALD PL",
            "city": "ROCK HILL",
            "state": "NY",
            "postal_code": "127756049",
            "telephone_number": "845-703-6999",
            "fax_number": "845-703-6297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBERMEYER",
        "first_name": "CARLI",
        "middle_name": "J.",
        "name_prefix": "Mrs.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-22",
        "last_updated": "2020-10-12",
        "certification_date": "2020-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "028475",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "carli.obermeyermpt.p1@direct.crystalrun.nextgenshare.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "61 Emerald Pl",
            "city": "Rock Hill",
            "state": "NY",
            "country_code": "US",
            "postal_code": "127756049",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "CARLI",
            "last_name": "VANWAGENEN",
            "middle_name": "J.",
            "prefix": "MS.",
            "credential": "P.T.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Michael A Miller, M.D.
• Neuroinfusion Registered Professional Nursing, PLLC (NeuroInfusion)
• Timothy Omokhogie Omogbai, REGISTERED NURSE
• Tapti Panda, M.D.
• Aruna S Panini, M.D.
• Heidi E Pavese, FNP
• Krystal Perrello

• Physical Therapist in Rock Hill, NY
• Providers in Rock Hill, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2020; 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.