Active NPI
Jennifer Bultman, P.T.
- Physical Therapist
- Waukesha, WI
National Provider Identifier
1073887113
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 11318-24
- Practice address
- 21075 Swenson Dr
Suite 600
Waukesha, WI 53186-2000 - Phone
- (262) 798-8646
- Fax
- (262) 798-8640
- NPI assigned
- Mar 7, 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 | 11318-24 | WI | Primary |
Addresses
Primary practice location
21075 Swenson Dr
Suite 600
Waukesha, WI 53186-2000
Mailing address
21075 Swenson Dr
Suite 600
Waukesha, WI 53186-2000
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Waukesha Physical Therapy Clinic | Physical Therapist | 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.
-
- Physical Therapist
- Hartland, WI
- NPI 1073599783
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1331078400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1331078400000",
"number": "1073887113",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21075 SWENSON DR",
"address_2": "SUITE 600",
"city": "WAUKESHA",
"state": "WI",
"postal_code": "531862000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21075 SWENSON DR",
"address_2": "SUITE 600",
"city": "WAUKESHA",
"state": "WI",
"postal_code": "531862000",
"telephone_number": "262-798-8646",
"fax_number": "262-798-8640"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BULTMAN",
"first_name": "JENNIFER",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-03-07",
"last_updated": "2012-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WI",
"license": "11318-24",
"primary": true
}
],
"identifiers": [],
"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 Mar 7, 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.