Individual provider Active NPI

Arianne R Stuckmeyer, MPT

  • Physical Therapist
  • Columbia, IL
National Provider Identifier
1811036684
Registry record updated Jun 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070025311 Issued in IL
Practice address
133 W Cascade Dr
Columbia, IL 62236-1101
Phone
(772) 559-7010
NPI assigned
Feb 6, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X
Physical Therapist 225100000X 009963 CT
Physical Therapist 225100000X PT21075 FL
Physical Therapist 225100000X 070025311 IL Primary

Addresses

Primary practice location

133 W Cascade Dr
Columbia, IL 62236-1101

Mailing address

133 W Cascade Dr
Columbia, IL 62236-1101
Phone (772) 559-7010

Other practice location 1

20 Germantown Rd
second floor
Danbury, CT 06810-5023
Phone (203) 798-6523

Other names 1

  • Arianne R De Gannes Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210716000171 IL Practitioner - Physical Therapist in Private Practice 8022184639 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Florida Atlantic University, College of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Schwegel Physical Therapy PCGroup PAC ID 0941334213, 14 clinicians

Practice addresses (Care Compare)

816 S Main St
Suite 1a
Columbia, IL 62236-2489
Phone (618) 636-2786

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
009963CTMDGeneral Practice Dentistry
9963CTMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Schwegel Physical Therapy PC Physical Therapist CurrentSince Nov 1, 2022 Accepting new patients
Danbury Radiological Associates, PC Past Accepting new patients
Danbury Hospital Past Accepting new patients
Alton Physical Therapy, P.C. Physical Therapist Past Accepting new patients
Vero Orthopaedics II PA PastSince Jul 1, 1997 Accepting new patients
Vero Orthopaedics II PA PastSince Aug 28, 2021 Accepting new patients

Locations

3550 College Ave
Alton, IL 62002
Phone (618) 462-1133

816 S Main St
Ste 1A
Columbia, IL 62236
Phone (618) 636-2786

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

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": "1623110400000",
    "number": "1811036684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 W CASCADE DR",
            "city": "COLUMBIA",
            "state": "IL",
            "postal_code": "622361101",
            "telephone_number": "772-559-7010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 W CASCADE DR",
            "city": "COLUMBIA",
            "state": "IL",
            "postal_code": "622361101",
            "telephone_number": "772-559-7010"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20 Germantown Rd",
            "address_2": "second floor",
            "address_purpose": "LOCATION",
            "city": "Danbury",
            "state": "CT",
            "postal_code": "068105023",
            "country_code": "US",
            "telephone_number": "203-798-6523",
            "fax_number": "203-798-0393",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STUCKMEYER",
        "first_name": "ARIANNE",
        "middle_name": "R",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-06",
        "last_updated": "2021-06-08",
        "certification_date": "2021-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "009963",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT21075",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070025311",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ARIANNE",
            "last_name": "DE GANNES",
            "middle_name": "R",
            "credential": "MPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Columbia, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.