Ther-a-Con Physical Therapy Inc

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

THER-A-CON PHYSICAL THERAPY INC

Practice address

2103 Myrtle Ave
Eureka, CA 95501-3323

Phone

(707) 445-9150

Fax

(707) 444-1372

NPI assigned

Dec 13, 2005

Organization subpart

No

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

Authorized official

Name

Mrs. Martie Johanna Van Werkum-Glidden, PTNPI 1215911748

Title

Physical Therapist

Phone

(707) 445-9150

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Martie Johanna Vanwerkum-Glidden, PT

  • Physical Therapist
  • Eureka, CA
  • NPI 1215911748
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1134432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1649255605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2103 MYRTLE AVE",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955013323",
            "telephone_number": "707-445-9150",
            "fax_number": "707-444-1372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2103 MYRTLE AVE",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955013323",
            "telephone_number": "707-445-9150",
            "fax_number": "707-444-1372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THER-A-CON PHYSICAL THERAPY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "VAN WERKUM-GLIDDEN",
        "authorized_official_first_name": "MARTIE",
        "authorized_official_middle_name": "JOHANNA",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "707-445-9150",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sean Elliot Tew
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• The Redwood Family Institute
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• Katrina L. Thernell, LCSW
• Alyssa Thom
• Daniel Levon Thomas, RN
• John Carleton Thomas

• Physical Therapist in Eureka, CA
• Providers in Eureka, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.