Individual provider Active NPI

Michael Philippi

  • Physical Therapy Assistant
  • Oshkosh, WI
National Provider Identifier
1043724925
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
1725-19 Issued in WI
Practice address
1130 N Westfield St
Oshkosh, WI 54902-3217
Phone
(920) 233-2340
NPI assigned
Nov 29, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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 1725-19 WI Primary

Addresses

Primary practice location

1130 N Westfield St
Oshkosh, WI 54902-3217

Mailing address

91 3Rd St
Fond Du Lac, WI 54935-4465
Phone (920) 573-5088

Other practice location 1

6810 W State St
Wauwatosa, WI 53213-2807
Phone (414) 259-0623

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
1725-19WIMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1511913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1043724925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "91 3RD ST",
            "city": "FOND DU LAC",
            "state": "WI",
            "postal_code": "549354465",
            "telephone_number": "920-573-5088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1130 N WESTFIELD ST",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549023217",
            "telephone_number": "920-233-2340"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6810 W State St",
            "address_purpose": "LOCATION",
            "city": "Wauwatosa",
            "state": "WI",
            "postal_code": "532132807",
            "country_code": "US",
            "telephone_number": "414-259-0623",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHILIPPI",
        "first_name": "MICHAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-11-29",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WI",
            "license": "1725-19",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oshkosh, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.