Individual provider Active NPI

Kaycee Carobine

  • Physical Therapy Assistant
  • Two Rivers, WI
National Provider Identifier
1023567930
Registry record updated Oct 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
249819 Issued in WI
Practice address
5300 Memorial Dr
Two Rivers, WI 54241-3923
Phone
(920) 793-7570
NPI assigned
Oct 4, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 249819 WI Primary

Addresses

Primary practice location

5300 Memorial Dr
Two Rivers, WI 54241-3923

Mailing address

W2310 County Rd S
Freedom, WI 54130-7226
Phone (715) 889-4765

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

LicenseStateTypeSpecialty
249819WIMDPhysical Therapy Assistant

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1475539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475539200000",
    "number": "1023567930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W2310 COUNTY RD S",
            "city": "FREEDOM",
            "state": "WI",
            "postal_code": "541307226",
            "telephone_number": "715-889-4765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5300 MEMORIAL DR",
            "city": "TWO RIVERS",
            "state": "WI",
            "postal_code": "542413923",
            "telephone_number": "920-793-7570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAROBINE",
        "first_name": "KAYCEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-04",
        "last_updated": "2016-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WI",
            "license": "249819",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Two Rivers, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2016; 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.