Sandra Carolyn Bertke, OTR/L – Occupational Therapist

Key facts

NPI: 1710150487
Entity type: Individual (NPI type 1)
Primary specialty: Occupational Therapist 225X00000X
License: 4403 (OH)
Practice address: 1915 Havemann Rd
Celina, OH 45822-9389
Phone: (419) 586-2100
NPI assigned: Apr 2, 2008
Sex: Female
Sole proprietor: Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Physiomax Rehab,LLC Physical Therapy Clinic/Center · Celina, OH · NPI 1912117458

NPD (past)

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

Practice roles

Organization	Specialty	Status	New patients
Physiomax Rehab,LLC		Past since Oct 17, 2007	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Occupational Therapist	225X00000X	4403	OH	Yes

Addresses

Primary practice location

1915 Havemann Rd
Celina, OH 45822-9389

Mailing address

1915 Havemann Rd
Celina, OH 45822-9389
Phone (419) 586-2100

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Apr 2, 2008.

{
    "created_epoch": "1207094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207094400000",
    "number": "1710150487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1915 HAVEMANN RD",
            "city": "CELINA",
            "state": "OH",
            "postal_code": "458229389",
            "telephone_number": "419-586-2100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1915 HAVEMANN RD",
            "city": "CELINA",
            "state": "OH",
            "postal_code": "458229389",
            "telephone_number": "419-586-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERTKE",
        "first_name": "SANDRA",
        "middle_name": "CAROLYN",
        "name_prefix": "Mrs.",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-02",
        "last_updated": "2008-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "OH",
            "license": "4403",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Celina, OH

All providers in Celina, OH · Occupational Therapist in Ohio

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 2, 2008. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.