Individual provider Active NPI

Annette Marie Weirick, LPTA

  • Physical Therapy Assistant
  • Fort Atkinson, WI
National Provider Identifier
1033139233
Registry record updated Mar 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
895-019 Issued in WI
Practice address
1504 Madison Avenue
Fort Atkinson, WI 53538-1996
Phone
(920) 563-9357
Fax
(920) 568-6545
NPI assigned
Jul 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2017

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 895-019 WI Primary

Addresses

Primary practice location

1504 Madison Avenue
Fort Atkinson, WI 53538-1996

Mailing address

1504 Madison Avenue
Fort Atkinson, WI 53538-1996
Phone (920) 563-9357

Other identifiers 1

IdentifierTypeStateIssuer
36107200MedicaidWI

Other names 1

  • Annette Marie Strege Former name

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
895-019WIMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490054400000",
    "number": "1033139233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1504 MADISON AVENUE",
            "city": "FORT ATKINSON",
            "state": "WI",
            "postal_code": "535381996",
            "telephone_number": "920-563-9357",
            "fax_number": "920-568-6545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1504 MADISON AVENUE",
            "city": "FORT ATKINSON",
            "state": "WI",
            "postal_code": "535381996",
            "telephone_number": "920-563-9357",
            "fax_number": "920-568-6545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEIRICK",
        "first_name": "ANNETTE",
        "middle_name": "MARIE",
        "credential": "LPTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-20",
        "last_updated": "2017-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WI",
            "license": "895-019",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "36107200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANNETTE",
            "last_name": "STREGE",
            "middle_name": "MARIE",
            "credential": "LPTA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fort Atkinson, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2017; 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.