NPIMap

Individual provider Active NPI

Danielle Cantu

  • Physical Therapist
  • Sheboygan Falls, WI
National Provider Identifier
1073789665
Registry record updated Sep 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
10679-024 Issued in WI
Practice address
531 Giddings Ave
Sheboygan Falls, WI 53085-1707
Phone
(920) 550-5254
NPI assigned
May 2, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 10679-024 WI Primary

Addresses

Primary practice location

531 Giddings Ave
Sheboygan Falls, WI 53085-1707

Mailing address

531 Giddings Ave
Sheboygan Falls, WI 53085-1707

Other identifiers 1

IdentifierTypeStateIssuer
36162500MedicaidWI

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
10679-024WIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
FMG Mead Avenue Wisconsin LLC 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1209686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379376000000",
    "number": "1073789665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "531 GIDDINGS AVE",
            "city": "SHEBOYGAN FALLS",
            "state": "WI",
            "postal_code": "530851707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "531 GIDDINGS AVE",
            "city": "SHEBOYGAN FALLS",
            "state": "WI",
            "postal_code": "530851707",
            "telephone_number": "920-550-5254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANTU",
        "first_name": "DANIELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-02",
        "last_updated": "2013-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "10679-024",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "36162500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sheboygan Falls, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2013; 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.