Individual provider Active NPI

Cassandra Maurer, PT, DPT

  • Pediatric Physical Therapist
  • Appleton, WI
National Provider Identifier
1669298238
Registry record updated Nov 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Physical TherapistTaxonomy code 2251P0200X
License
16305-24 Issued in WI
Practice address
2575 E Evergreen Dr
Appleton, WI 54913-8910
Phone
(920) 969-5353
NPI assigned
Nov 28, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Physical Therapist 2251P0200X 16305-24 WI Primary

Addresses

Primary practice location

2575 E Evergreen Dr
Appleton, WI 54913-8910

Mailing address

28 Diane LN
Appleton, WI 54915-7204

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
16305-24WIMDPediatric Physical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1732752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732752000000",
    "number": "1669298238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 DIANE LN",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549157204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2575 E EVERGREEN DR",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549138910",
            "telephone_number": "920-969-5353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAURER",
        "first_name": "CASSANDRA",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-28",
        "last_updated": "2024-11-28",
        "certification_date": "2024-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "WI",
            "license": "16305-24",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Appleton, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2024; 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.