Individual provider Active NPI

Donna S. Sebo, PTA

  • Physical Therapy Assistant
  • Green Bay, WI
National Provider Identifier
1760521678
Registry record updated Feb 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
998-019 Issued in WI
Practice address
2801 S Webster Ave
CP Center Inc
Green Bay, WI 54301-2878
Phone
(920) 337-1122
Fax
(920) 337-1126
NPI assigned
Feb 6, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2017

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 998-019 WI Primary

Addresses

Primary practice location

2801 S Webster Ave
CP Center Inc
Green Bay, WI 54301-2878

Mailing address

2801 S Webster Ave
CP Center Inc
Green Bay, WI 54301-2878
Phone (920) 337-1122

Other names 1

  • Donna S. Rathsack 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

State licenses

LicenseStateTypeSpecialty
998-019WIMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488240000000",
    "number": "1760521678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 S WEBSTER AVE",
            "address_2": "CP CENTER INC",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543012878",
            "telephone_number": "920-337-1122",
            "fax_number": "920-337-1126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 S WEBSTER AVE",
            "address_2": "CP CENTER INC",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543012878",
            "telephone_number": "920-337-1122",
            "fax_number": "920-337-1126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEBO",
        "first_name": "DONNA",
        "middle_name": "S.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-06",
        "last_updated": "2017-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WI",
            "license": "998-019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DONNA",
            "last_name": "RATHSACK",
            "middle_name": "S.",
            "credential": "PTA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 Feb 28, 2017; 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.