Active NPI
Erin E Doxtator, PT
- Physical Therapist
- Waukesha, WI
National Provider Identifier
1063454734
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 6204-024
- Practice address
- 1111 Delafield St
Suite 120
Waukesha, WI 53188-3417 - Phone
- (262) 521-9762
- Fax
- (262) 521-1091
- NPI assigned
- Jun 10, 2006
- Last updated
- Aug 29, 2012
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 6204-024 | WI | Primary |
Addresses
Primary practice location
1111 Delafield St
Suite 120
Waukesha, WI 53188-3417
Mailing address
790 Remington Blvd
Bolingbrook, IL 60440-4909
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 36114000 | 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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6204-024 | WI | MD | Physical Therapist |
| 6204 | WI | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Orthopaedic Associates of Wisconsin, SC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
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- Pewaukee, WI
- NPI 1689656951
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149897600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1346198400000",
"number": "1063454734",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "790 REMINGTON BLVD",
"city": "BOLINGBROOK",
"state": "IL",
"postal_code": "604404909"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1111 DELAFIELD ST",
"address_2": "SUITE 120",
"city": "WAUKESHA",
"state": "WI",
"postal_code": "531883417",
"telephone_number": "262-521-9762",
"fax_number": "262-521-1091"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOXTATOR",
"first_name": "ERIN",
"middle_name": "E",
"name_prefix": "Ms.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-10",
"last_updated": "2012-08-29",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WI",
"license": "6204-024",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "36114000",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Waukesha, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.