Carol J Feldewerth, PTA
Individual provider Active NPI Physical Therapy Assistant · Godfrey, IL
NPI 1760939433 · NPPES record last updated Sep 9, 2016
Key facts
- NPI
- 1760939433
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- 160.001976 (IL)
- Practice address
- 1373 Dadrian Professional Park
Godfrey, IL 62035-1767 - Phone
- (618) 467-7062
- NPI assigned
- Sep 9, 2016
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 160.001976 | IL | MD | Physical Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 160.001976 | IL | Yes |
Addresses
Primary practice location
1373 Dadrian Professional Park
Godfrey, IL 62035-1767
Mailing address
117 Fox Hill CT
Edwardsville, IL 62025-5736
Phone (618) 444-3528
Other providers in Godfrey, IL
- Stephanie Duke
- Elaine Edwards
- Lucas Edwards
- Tracie Lynn Eilerman
- Mary E Elliott
- Callie Ann Feldman
- Mark Edward Ferguson
- Lori Lynn Ford
- Allison Chelsea Fowler
- Maura Fredrick
All providers in Godfrey, IL · Physical Therapy Assistant in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 9, 2016. 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.