Active NPI
Richard E Meyer, PTA
- Physical Therapy Assistant
- Elkhorn, WI
National Provider Identifier
1861675464
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 852
- Practice address
- W3985 County Road NN
Elkhorn, WI 53121-4337 - Phone
- (262) 741-2000
- NPI assigned
- Dec 6, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 852 | WI | Primary |
Addresses
Primary practice location
W3985 County Road NN
Elkhorn, WI 53121-4337
Mailing address
W3985 County Road NN
Elkhorn, WI 53121-4337
Phone (262) 741-2000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 36106600 | Medicaid | WI |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 852 | WI | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1196899200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1196899200000",
"number": "1861675464",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "W3985 COUNTY ROAD NN",
"city": "ELKHORN",
"state": "WI",
"postal_code": "531214337",
"telephone_number": "262-741-2000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "W3985 COUNTY ROAD NN",
"city": "ELKHORN",
"state": "WI",
"postal_code": "531214337",
"telephone_number": "262-741-2000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEYER",
"first_name": "RICHARD",
"middle_name": "E",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-12-06",
"last_updated": "2007-12-06",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "WI",
"license": "852",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "36106600",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Elkhorn, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 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.