Active NPI
Jane Marie Frazier, P.T.
- Specialist
- Stoughton, WI
National Provider Identifier
1053528083
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 1674-024
- Practice address
- 814 Jackson St
Stoughton, WI 53589-1520 - Phone
- (608) 873-6448
- NPI assigned
- May 17, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Specialist | 174400000X | 1674-024 | WI | Primary |
Addresses
Primary practice location
814 Jackson St
Stoughton, WI 53589-1520
Mailing address
585 Cty Hwy PB
Belleville, WI 53508
Phone (608) 424-6221
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 40133200 | 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 |
|---|---|---|---|
| 1674-024 | WI | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179360000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1053528083",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "585 CTY HWY PB",
"city": "BELLEVILLE",
"state": "WI",
"postal_code": "53508",
"telephone_number": "608-424-6221"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "814 JACKSON ST",
"city": "STOUGHTON",
"state": "WI",
"postal_code": "535891520",
"telephone_number": "608-873-6448"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FRAZIER",
"first_name": "JANE",
"middle_name": "MARIE",
"name_prefix": "Ms.",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-17",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "WI",
"license": "1674-024",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "40133200",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Stoughton, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.