Active NPI
Kylie Colwell
- Physical Therapy Assistant
- Shawano, WI
National Provider Identifier
1083592588
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 4298-19
- Practice address
- 1250 S Evergreen St
Shawano, WI 54166-3514 - Phone
- (715) 526-3107
- NPI assigned
- Aug 22, 2025
- Last updated
- Aug 22, 2025
- Sex
- Unspecified or another gender identity
- 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 Therapy Assistant | 225200000X | 4298-19 | WI | Primary |
Addresses
Primary practice location
1250 S Evergreen St
Shawano, WI 54166-3514
Mailing address
370 Longwood LN
Wrightstown, WI 54180-1224
Other practice location 1
1475 Birch Hill Ln
Shawano, WI 54166-3707
Phone (715) 526-3161
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 |
|---|---|---|---|
| 4298-19 | WI | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1755820800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1755820800000",
"number": "1083592588",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "370 LONGWOOD LN",
"city": "WRIGHTSTOWN",
"state": "WI",
"postal_code": "541801224"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1250 S EVERGREEN ST",
"city": "SHAWANO",
"state": "WI",
"postal_code": "541663514",
"telephone_number": "715-526-3107"
}
],
"practiceLocations": [
{
"address_1": "1475 Birch Hill Ln",
"address_purpose": "LOCATION",
"city": "Shawano",
"state": "WI",
"postal_code": "541663707",
"country_code": "US",
"telephone_number": "715-526-3161",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "COLWELL",
"first_name": "KYLIE",
"sole_proprietor": "NO",
"sex": "X",
"enumeration_date": "2025-08-22",
"last_updated": "2025-08-22",
"certification_date": "2025-08-22",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "WI",
"license": "4298-19",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Shawano, WI
- Casey M Carroll
- Deborah Chinana, LPC
- Eleanor Kline Claycomb, M.ED L.C.S.W.
- Vickiemarie Cloutier, MD
- Jane Laurie Coleman, MSE,LPC
- Cornerstone Chiropractic & Wellness LLC
- Countryview Chiropractic Clinic, S.C.
- County of Shawano (Maple Lane Health Care Center)
- County of Shawano (Shawano County Health Department)
- County of Shawano (Shawano County Dept of Human Services-Lakeland Center Crisis SVCS)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.