Active NPI
Stephania Vertin, PT
- Physical Therapist
- Green Bay, WI
National Provider Identifier
1730660291
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 14408-24
- Practice address
- 1640 Shawano Ave
Green Bay, WI 54303-3214 - Phone
- (920) 499-5177
- NPI assigned
- Aug 23, 2018
- 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 | 14408-24 | WI | Primary |
Addresses
Primary practice location
1640 Shawano Ave
Green Bay, WI 54303-3214
Mailing address
1000 Fianna Way
Fort Smith, AR 72919-3872
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 |
|---|---|---|---|
| 14408-24 | WI | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1534982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1534982400000",
"number": "1730660291",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1000 FIANNA WAY",
"city": "FORT SMITH",
"state": "AR",
"postal_code": "729193872",
"fax_number": "479-478-2516"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1640 SHAWANO AVE",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "543033214",
"telephone_number": "920-499-5177"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VERTIN",
"first_name": "STEPHANIA",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-08-23",
"last_updated": "2018-08-23",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WI",
"license": "14408-24",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Green Bay, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.