Individual provider Active NPI

Danielle Christine Wittich, PTA

  • Physical Therapy Assistant
  • St Louis Park, MN
National Provider Identifier
1730350083
Registry record updated Mar 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
Practice address
4415 W 36 1/2 St
St Louis Park, MN 55416-4854
Phone
(952) 927-9717
NPI assigned
Mar 14, 2008
Last updated
Mar 14, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2008

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 NU Primary

Addresses

Primary practice location

4415 W 36 1/2 St
St Louis Park, MN 55416-4854

Mailing address

4415 W 36 1/2 St
St Louis Park, MN 55416-4854
Phone (952) 927-9717

Other names 1

  • Danielle Christine Doering Former name

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

NPI Registry JSON

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

{
    "created_epoch": "1205452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205452800000",
    "number": "1730350083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4415 W 36 1/2 ST",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554164854",
            "telephone_number": "952-927-9717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4415 W 36 1/2 ST",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554164854",
            "telephone_number": "952-927-9717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITTICH",
        "first_name": "DANIELLE",
        "middle_name": "CHRISTINE",
        "name_prefix": "Mrs.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-14",
        "last_updated": "2008-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DANIELLE",
            "last_name": "DOERING",
            "middle_name": "CHRISTINE",
            "credential": "PTA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in St Louis Park, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2008; 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.