Debra Lynn Ahlborn, COTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

668027 Issued in WI

Practice address

3939 S 92ND St
Clement Manor
Greenfield, WI 53228-1455

Phone

(414) 546-7346

Fax

(414) 546-1825

NPI assigned

Apr 18, 2007

Sex

Female

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

• Debra Lynn Nash Other name

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1013133040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3744 W HOLMES AVE",
            "city": "GREENFIELD",
            "state": "WI",
            "postal_code": "532212516",
            "telephone_number": "414-282-2049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3939 S 92ND ST",
            "address_2": "CLEMENT MANOR",
            "city": "GREENFIELD",
            "state": "WI",
            "postal_code": "532281455",
            "telephone_number": "414-546-7346",
            "fax_number": "414-546-1825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHLBORN",
        "first_name": "DEBRA",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WI",
            "license": "668027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEBRA",
            "last_name": "NASH",
            "middle_name": "LYNN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• All providers in Greenfield, WI
• Physical Therapy Assistant in Wisconsin

• 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.

Verify at the official NPI Registry.