Emily Jo Bavin, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

1989-19 Issued in WI

Practice address

750 East Lousiana St
St. Croix Falls, WI 54204

Phone

(715) 483-2713

Fax

(715) 483-2725

NPI assigned

Apr 30, 2013

Last updated

Apr 30, 2013By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Emily Jo Perrault Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1367280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367280000000",
    "number": "1689019903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 EAST LOUSIANA ST",
            "city": "ST. CROIX FALLS",
            "state": "WI",
            "postal_code": "54204",
            "telephone_number": "715-483-2713",
            "fax_number": "715-483-2725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 EAST LOUSIANA ST",
            "city": "ST. CROIX FALLS",
            "state": "WI",
            "postal_code": "54204",
            "telephone_number": "715-483-2713",
            "fax_number": "715-483-2725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAVIN",
        "first_name": "EMILY",
        "middle_name": "JO",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-04-30",
        "last_updated": "2013-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WI",
            "license": "1989-19",
            "primary": true
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MN",
            "license": "A1421",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EMILY",
            "last_name": "PERRAULT",
            "middle_name": "JO",
            "credential": "PTA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jodi R Arrowood, PHARMD
• Heather J Ash, NP
• Alexander Austing, OD
• Semi Ayub, M.D
• Holly Andrea Bailey, PHD
• Penny Lynn Bearheart, LPC, SAC
• Jennifer Diane Beauvais, NP
• Jill Lorraine Bednar, ATC, LAT
• Erik H Belgum, SLP
• Krista A Bellrichard, PT

• Physical Therapy Assistant in Saint Croix Falls, WI
• Providers in Saint Croix Falls, WI by specialty
• Physical Therapy Assistant in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2013; 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.