Active NPI
Sheila Diane Gamm, PTA
- Physical Therapy Assistant
- Sedalia, MO
National Provider Identifier
1962774752
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 2011036406
- Practice address
- 25023 Bothwell Park Rd
Sedalia, MO 65301-0084 - Phone
- (573) 826-1564
- NPI assigned
- Feb 8, 2012
- 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 |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 2011036406 | MO | Primary |
Addresses
Primary practice location
25023 Bothwell Park Rd
Sedalia, MO 65301-0084
Mailing address
PO Box 2414
Lake Ozark, MO 65049-2414
Phone (573) 280-2000
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 |
|---|---|---|---|
| 2011036406 | MO | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1328659200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1328659200000",
"number": "1962774752",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2414",
"city": "LAKE OZARK",
"state": "MO",
"postal_code": "650492414",
"telephone_number": "573-280-2000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25023 BOTHWELL PARK RD",
"city": "SEDALIA",
"state": "MO",
"postal_code": "653010084",
"telephone_number": "573-826-1564"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAMM",
"first_name": "SHEILA",
"middle_name": "DIANE",
"name_prefix": "Mrs.",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-02-08",
"last_updated": "2012-02-08",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "MO",
"license": "2011036406",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sedalia, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.