Individual provider Active NPI

Patty Lynn Goldammer, LPTA

  • Physical Therapy Assistant
  • Cheboygan, MI
National Provider Identifier
1679902142
Registry record updated Feb 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
5502003468 Issued in MI
Practice address
761 Lafayette Ave
Cheboygan, MI 49721-2117
Phone
(231) 627-2031
NPI assigned
Nov 5, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2021

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 5502003468 MI Primary

Addresses

Primary practice location

761 Lafayette Ave
Cheboygan, MI 49721-2117

Mailing address

761 Lafayette Ave
Cheboygan, MI 49721-2117
Phone (231) 627-2031

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
5502003468MIMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1383609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612483200000",
    "number": "1679902142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "761 LAFAYETTE AVE",
            "city": "CHEBOYGAN",
            "state": "MI",
            "postal_code": "497212117",
            "telephone_number": "231-627-2031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "761 LAFAYETTE AVE",
            "city": "CHEBOYGAN",
            "state": "MI",
            "postal_code": "497212117",
            "telephone_number": "231-627-2031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDAMMER",
        "first_name": "PATTY",
        "middle_name": "LYNN",
        "credential": "LPTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-05",
        "last_updated": "2021-02-05",
        "certification_date": "2021-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MI",
            "license": "5502003468",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cheboygan, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2021; 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.