NPIMap

Individual provider Active NPI

Terri Lynn Dama, PT

  • Physical Therapist
  • Oconto Falls, WI
National Provider Identifier
1811135338
Registry record updated Feb 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2355-24 Issued in WI
Practice address
855 S Main St
Oconto Falls, WI 54154-1241
Phone
(920) 846-3444
Fax
(920) 846-0754
NPI assigned
Jan 22, 2009
Last updated
Feb 5, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2355-24 WI Primary

Addresses

Primary practice location

855 S Main St
Oconto Falls, WI 54154-1241

Mailing address

855 S Main St
Oconto Falls, WI 54154-1241
Phone (920) 846-3444

Other identifiers 3

IdentifierTypeStateIssuer
1851477913OtherWICMH NPI
11014110MedicaidWI
390848401050OtherWIBLUE CROSS BLUE SHIELD

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
2355-24WIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
St Clare Memorial Hospital, Inc. Past Accepting new patients
Community Memorial Hospital, Incorporated Past Accepting new patients
St Clare Memorial Hospital, Inc Past Accepting new patients
Community Memorial Hospital, Incorporated Past Accepting new patients
Community Memorial Hospital Past Accepting new patients
Community Memorial Hospital, Incorporated Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://eprescribe.sanfordhealth.org/FHIR/api/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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1232582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423094400000",
    "number": "1811135338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "855 S MAIN ST",
            "city": "OCONTO FALLS",
            "state": "WI",
            "postal_code": "541541241",
            "telephone_number": "920-846-3444",
            "fax_number": "920-846-0754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "855 S MAIN ST",
            "city": "OCONTO FALLS",
            "state": "WI",
            "postal_code": "541541241",
            "telephone_number": "920-846-3444",
            "fax_number": "920-846-0754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAMA",
        "first_name": "TERRI",
        "middle_name": "LYNN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-22",
        "last_updated": "2015-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "2355-24",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CMH NPI",
            "identifier": "1851477913",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "11014110",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "390848401050",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oconto Falls, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2015; 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.