Individual provider Active NPI

Tara Annette Glosemeyer, LPTA

  • Physical Therapy Assistant
  • Rock Hill, SC
National Provider Identifier
1649397001
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
585 Issued in SC
Practice address
831 McDow Dr
Rock Hill, SC 29732-2415
Phone
(803) 366-5722
NPI assigned
Mar 23, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 585 SC Primary

Addresses

Primary practice location

831 McDow Dr
Rock Hill, SC 29732-2415

Mailing address

3326 Goodplace Rd
Rock Hill, SC 29732-9264
Phone (803) 324-7852

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
585SCMDPediatric Occupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1649397001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3326 GOODPLACE RD",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297329264",
            "telephone_number": "803-324-7852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "831 MCDOW DR",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297322415",
            "telephone_number": "803-366-5722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLOSEMEYER",
        "first_name": "TARA",
        "middle_name": "ANNETTE",
        "credential": "LPTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "SC",
            "license": "585",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rock Hill, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.