Active NPI
Pamela Gerda Vette Burgardt, PT
- Physical Therapist
- Watertown, WI
National Provider Identifier
1689647828
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 4577024
- Practice address
- 1020 Hill St
Watertown, WI 53098-3016 - Phone
- (920) 206-4935
- Fax
- (920) 206-4986
- NPI assigned
- Feb 8, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 4577024 | WI | Primary |
Addresses
Primary practice location
1020 Hill St
Watertown, WI 53098-3016
Mailing address
1020 Hill St
Watertown, WI 53098-3016
Phone (920) 206-4935
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
| License | State | Type | Specialty |
|---|---|---|---|
| 4577024 | WI | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139356800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1373587200000",
"number": "1689647828",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1020 HILL ST",
"city": "WATERTOWN",
"state": "WI",
"postal_code": "530983016",
"telephone_number": "920-206-4935",
"fax_number": "920-206-4986"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1020 HILL ST",
"city": "WATERTOWN",
"state": "WI",
"postal_code": "530983016",
"telephone_number": "920-206-4935",
"fax_number": "920-206-4986"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VETTE BURGARDT",
"first_name": "PAMELA",
"middle_name": "GERDA",
"name_prefix": "Mrs.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-02-08",
"last_updated": "2013-07-12",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WI",
"license": "4577024",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Watertown, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 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.