Individual provider Active NPI

Daniel Kahlscheuer, PTA

  • Physical Therapy Assistant
  • Fond Du Lac, WI
National Provider Identifier
1114460805
Registry record updated Nov 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
2492-19 Issued in WI
Practice address
103 S Pioneer Rd
Fond Du Lac, WI 54935-3800
Phone
(920) 922-7776
Fax
(920) 922-2938
NPI assigned
Nov 29, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 29, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 2492-19 WI Primary

Addresses

Primary practice location

103 S Pioneer Rd
Fond Du Lac, WI 54935-3800

Mailing address

1301 Rosehill Rd
Apt 88
Little Chute, WI 54140-2472
Phone (920) 535-0552

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
2492-19WIMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1480377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480377600000",
    "number": "1114460805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 ROSEHILL RD",
            "address_2": "APT 88",
            "city": "LITTLE CHUTE",
            "state": "WI",
            "postal_code": "541402472",
            "telephone_number": "920-535-0552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 S PIONEER RD",
            "city": "FOND DU LAC",
            "state": "WI",
            "postal_code": "549353800",
            "telephone_number": "920-922-7776",
            "fax_number": "920-922-2938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAHLSCHEUER",
        "first_name": "DANIEL",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-11-29",
        "last_updated": "2016-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WI",
            "license": "2492-19",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fond Du Lac, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2016; 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.