Individual provider Active NPI

Carolyn Rodenkirch, PT

  • Physical Therapist
  • Milwaukee, WI
National Provider Identifier
1124073069
Registry record updated Jul 31, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2534 Issued in WI
Practice address
3056 S Kinnickinnic Ave
Milwaukee, WI 53207-2521
Phone
(414) 769-4949
Fax
(414) 769-4935
NPI assigned
May 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2007

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 2534 WI Primary

Addresses

Primary practice location

3056 S Kinnickinnic Ave
Milwaukee, WI 53207-2521

Mailing address

3056 S Kinnickinnic Ave
Milwaukee, WI 53207-2521

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

NPI Registry JSON

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

{
    "created_epoch": "1148256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1185840000000",
    "number": "1124073069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3056 S KINNICKINNIC AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532072521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3056 S KINNICKINNIC AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532072521",
            "telephone_number": "414-769-4949",
            "fax_number": "414-769-4935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODENKIRCH",
        "first_name": "CAROLYN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-22",
        "last_updated": "2007-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "2534",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2007; 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.