{"npi":"1336293448","type":"NPI-1","status":"active","name":{"display":"Mrs. Gina Bandholz Pt","other":[{"code":"1","type":"Formerly known as","value":"WANKE, GINA MARIE"}],"first":"GINA","last":"BANDHOLZ","middle":"MARIE","credential":"PT"},"specialty":{"primary_taxonomy":"225100000X","primary_taxonomy_description":"Physical Therapist","slug":"physical-therapist","schema_org_specialty":null,"all":[{"code":"225100000X","description":"Physical Therapist","primary":true,"state":"WI","license":"4942-024"}]},"addresses":[{"purpose":"LOCATION","street_1":"N112W17975 MEQUON RD","city":"GERMANTOWN","state":"WI","postal_code":"530222425","country_code":"US","phone":"2625327600"},{"purpose":"MAILING","street_1":"1327 WINDY KNOLL DR","city":"HUBERTUS","state":"WI","postal_code":"530339302","country_code":"US","phone":"2626283608"}],"license":{"state":"WI","number":"4942-024"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"1336293448","state":"WI","issuer":null}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20100610000041","type_code":"14-65","type_desc":"PRACTITIONER - PHYSICAL THERAPIST IN PRIVATE PRACTICE","state":"WI","pac_id":"9830229343"}]},"enumeration_date":"2007-01-23","last_updated":"2021-12-07","_meta":{"source":"NPPES","snapshot_date":"2021-12-07","doc_url":"https://findmynpi.com/api"}}