NPIMap

Organization Active NPI

Makovicka Sylliaasen PC

  • Physical Therapist
  • Wahoo, NE
National Provider Identifier
1770539249
Registry record updated Jul 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
MAKOVICKA SYLLIAASEN PC
Practice address
559 W 15TH St
Wahoo, NE 68066-1280
Phone
(402) 443-4555
Fax
(402) 443-4554
NPI assigned
May 26, 2006
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Cory Sylliaasen, PT
Title
President
Phone
(402) 443-4555

Practitioners 40

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 40

National Provider Directory

National Provider Directory

Locations

111 S 9th St
Beatrice, NE 68310
Phone (402) 228-7303

8207 Northwoods Dr
Ste 102
Lincoln, NE 68505
Phone (402) 466-0555

559 W 15th St
Wahoo, NE 68066
Phone (402) 420-4545

13851 Guildford St
#2
Waverly, NE 68462
Phone (402) 786-0476

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

NPPES NPI Registry

Primary practice location

559 W 15TH St
Wahoo, NE 68066-1280

Mailing address

PO Box 427
Wahoo, NE 68066-0427
Phone (420) 443-4555

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
10025247500MedicaidNE

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 3, 2013.

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1372809600000",
    "number": "1770539249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 427",
            "city": "WAHOO",
            "state": "NE",
            "postal_code": "680660427",
            "telephone_number": "420-443-4555",
            "fax_number": "402-443-4554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "559 W 15TH ST",
            "city": "WAHOO",
            "state": "NE",
            "postal_code": "680661280",
            "telephone_number": "402-443-4555",
            "fax_number": "402-443-4554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAKOVICKA SYLLIAASEN PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-26",
        "last_updated": "2013-07-03",
        "status": "A",
        "authorized_official_last_name": "SYLLIAASEN",
        "authorized_official_first_name": "CORY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "402-443-4555",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025247500",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wahoo, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2013; 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.