Active NPI
Sandra S Pearson, PT
- Pediatric Physical Therapist
- Mequon, WI
National Provider Identifier
1902983133
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Physical Therapist
- License
- 2566-024
- Practice address
- 10602 N Port Washington Rd Ste 101
Mequon, WI 53092-5079 - Phone
- (262) 241-8030
- NPI assigned
- Nov 1, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Pediatric Physical Therapist | 2251P0200X | 2566-024 | WI | Primary |
Addresses
Primary practice location
10602 N Port Washington Rd Ste 101
Mequon, WI 53092-5079
Mailing address
W162N10554 Auburn LN
Germantown, WI 53022-4184
Phone (262) 253-0524
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 |
|---|---|---|---|
| 2566-024 | WI | MD | Pediatric Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162339200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1902983133",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "W162N10554 AUBURN LN",
"city": "GERMANTOWN",
"state": "WI",
"postal_code": "530224184",
"telephone_number": "262-253-0524"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10602 N PORT WASHINGTON RD STE 101",
"city": "MEQUON",
"state": "WI",
"postal_code": "530925079",
"telephone_number": "262-241-8030"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEARSON",
"first_name": "SANDRA",
"middle_name": "S",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2251P0200X",
"taxonomy_group": "",
"desc": "Physical Therapist, Pediatrics",
"state": "WI",
"license": "2566-024",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mequon, WI
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.