Kameliya Stoyanova Gancheva, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

2863-19 Issued in WI

Practice address

9401 Old Sauk Rd
Middleton, WI 53562-4409

Phone

(608) 535-5056

NPI assigned

Jun 21, 2021

Last updated

Jun 21, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1624233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624233600000",
    "number": "1902475221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4620 FREY ST APT 111",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537052903",
            "telephone_number": "608-844-4145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9401 OLD SAUK RD",
            "city": "MIDDLETON",
            "state": "WI",
            "postal_code": "535624409",
            "telephone_number": "608-535-5056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANCHEVA",
        "first_name": "KAMELIYA",
        "middle_name": "STOYANOVA",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-21",
        "last_updated": "2021-06-21",
        "certification_date": "2021-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WI",
            "license": "2863-19",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapy Assistant in Middleton, WI
• Providers in Middleton, WI by specialty
• Physical Therapy Assistant in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2021; 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.