Individual provider Active NPI

Karen Barbara Goercke, P.T.

  • Physical Therapist
  • Bayport, NY
National Provider Identifier
1831225333
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
005674-1 Issued in NY
Practice address
3 Damaris CT
Bayport, NY 11705-1763
Phone
(631) 472-2482
Fax
(631) 472-5419
NPI assigned
Feb 26, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 005674-1 NY Primary

Addresses

Primary practice location

3 Damaris CT
Bayport, NY 11705-1763

Mailing address

3 Damaris CT
Bayport, NY 11705-1763
Phone (631) 472-2482

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
005674-1NYMDPatient Transport Registered Respiratory Therapist

NPI Registry JSON

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1831225333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 DAMARIS CT",
            "city": "BAYPORT",
            "state": "NY",
            "postal_code": "117051763",
            "telephone_number": "631-472-2482",
            "fax_number": "631-472-5419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 DAMARIS CT",
            "city": "BAYPORT",
            "state": "NY",
            "postal_code": "117051763",
            "telephone_number": "631-472-2482",
            "fax_number": "631-472-5419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOERCKE",
        "first_name": "KAREN",
        "middle_name": "BARBARA",
        "name_prefix": "Mrs.",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "005674-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayport, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.