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Newly Listed Provider — this NPI profile has been added to the NPI registry within the last 90 days.

MIRELLA A GATTERDAM DPT
NPI 1053247684
Physical Therapist - Pediatrics in Elkhorn, NE

Active since June 22, 2026
20502 ROOSEVELT ST, ELKHORN, NE 68022(402) 955-8000(402) 955-8001 Get Directions Write a Review

NPPES record added: June 23, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Mirella A Gatterdam Dpt NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MIRELLA A GATTERDAM DPT (NPI 1053247684) is an individual pediatrics provider in Elkhorn, Nebraska, licensed in Nebraska (4979) and active in the NPI registry since June 2026.

NPPES Registry Identity

NPI1053247684
Entity TypeIndividualFemale
Primary Taxonomy2251P0200X
Provider Legal NameMIRELLA A GATTERDAMCredential: DPT
Location Address20502 ROOSEVELT STElkhorn, NE 68022-4148
Mailing AddressPo Box 24607Omaha, NE 68124-0607 · (402) 955-5400 · Fax (402) 955-3674
Phone(402) 955-8000
Fax(402) 955-8001
Sole ProprietorNo
Enumeration DateJune 22, 2026
Last NPPES UpdateJune 23, 2026
NPPES CertifiedJune 23, 2026
✔ NPI 1053247684 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysical Therapist · PediatricsRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code2251P0200X
License✔ Licensed in NE · 4979
Definition
A licensed physical therapist, including but not limited to an individual who is a Board Certified Specialist in Pediatric Physical Therapy, who has demonstrated specialized knowledge and skill in anatomy, histology, including embryonic development, genetics, biomechanics, neurological function, neuroscience, and pathology, behavioral sciences, and understanding of diseases or conditions that necessitate physical therapy care, that affect systems that in turn necessitate physical therapy care (comorbidities), and that influence the type of intervention that can be given.
20502 ROOSEVELT ST, Elkhorn, NE 68022
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Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ALLISON R OCEL AUD
Audiologist-Hearing Aid Fitter
20502 ROOSEVELT ST
ELKHORN, NE 68022
Douglas County (402) 955-3981
KODY A MOFFATT M.D.
Pediatrics (Sports Medicine)
20502 ROOSEVELT ST
ELKHORN, NE 68022
Douglas County (402) 955-7529
ABIGAIL REBECCA SQUIRE
Occupational Therapist (Pediatrics)
20502 ROOSEVELT ST
ELKHORN, NE 68022
Douglas County (402) 955-6319
DR. BENJAMIN AARON FUGITT PT, DPT, CSCS
Physical Therapist (Sports)
20502 ROOSEVELT ST
ELKHORN, NE 68022
Douglas County (402) 955-8181
DR. JUSTIN L BLATCHFORD PT
Physical Therapist (Pediatrics)
20502 ROOSEVELT ST
ELKHORN, NE 68022
Douglas County (402) 955-8181
JULIE M THORNTON AUD
Audiologist-Hearing Aid Fitter
20502 ROOSEVELT ST
ELKHORN, NE 68022
Douglas County (402) 955-8000

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mirella Gatterdam's NPI number?

The NPI number for Mirella Gatterdam is 1053247684. It was assigned to this individual provider in the NPPES registry on June 22, 2026.

Where is Mirella Gatterdam located?

Mirella Gatterdam practices at 20502 Roosevelt St, Elkhorn, NE 68022. The listed phone number is (402) 955-8000.

What is Mirella Gatterdam's specialty?

The primary specialty registered for this NPI is Physical Therapist, specializing in Pediatrics, with taxonomy code 2251P0200X.

When was this NPI record last updated?

The NPPES record for Mirella Gatterdam was last updated on June 23, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 52 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.