Active NPI
Jeffrey S Serchen, PT
- Physical Therapist
- Kenosha, WI
National Provider Identifier
1013040724
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 3844
- Practice address
- 7540 22ND Ave
Kenosha, WI 53143-5702 - Phone
- (262) 656-7800
- NPI assigned
- Mar 13, 2007
- Sex
- Male
- 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 Therapist | 225100000X | 3844 | WI | Primary |
Addresses
Primary practice location
7540 22ND Ave
Kenosha, WI 53143-5702
Mailing address
26129 Windermere Dr
Wind Lake, WI 53185-2747
Phone (262) 895-3589
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 40251800 | Medicaid | WI |
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 |
|---|---|---|---|
| 3844 | WI | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173744000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1013040724",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "26129 WINDERMERE DR",
"city": "WIND LAKE",
"state": "WI",
"postal_code": "531852747",
"telephone_number": "262-895-3589"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7540 22ND AVE",
"city": "KENOSHA",
"state": "WI",
"postal_code": "531435702",
"telephone_number": "262-656-7800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SERCHEN",
"first_name": "JEFFREY",
"middle_name": "S",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WI",
"license": "3844",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "40251800",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Kenosha, 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.