Active NPI
Andra Roselyn Gaarder, P.T.
- Physical Therapist
- Madison, WI
National Provider Identifier
1700115383
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 11266-24
- Practice address
- 333 West Main St.
Madison, WI 53703 - Phone
- (608) 283-2023
- NPI assigned
- Dec 10, 2009
- 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 | 11266-24 | WI | Primary |
Addresses
Primary practice location
333 West Main St.
Madison, WI 53703
Mailing address
4560 SE International Way
Ste. 100
Milwaukie, OR 97222
Phone (971) 206-5202
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 |
|---|---|---|---|
| 11266-24 | WI | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1260403200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1260403200000",
"number": "1700115383",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4560 SE INTERNATIONAL WAY",
"address_2": "STE. 100",
"city": "MILWAUKIE",
"state": "OR",
"postal_code": "97222",
"telephone_number": "971-206-5202",
"fax_number": "971-206-5203"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "333 WEST MAIN ST.",
"city": "MADISON",
"state": "WI",
"postal_code": "53703",
"telephone_number": "608-283-2023"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAARDER",
"first_name": "ANDRA",
"middle_name": "ROSELYN",
"name_prefix": "Ms.",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-12-10",
"last_updated": "2009-12-10",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WI",
"license": "11266-24",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Madison, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.