Active NPI
Jennifer Eldridge
- Physical Therapy Assistant
- Marinette, WI
National Provider Identifier
1124474093
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 2353-19
- Practice address
- 831 Pine Beach Rd
Marinette, WI 54143-4225 - Phone
- (715) 732-0155
- NPI assigned
- May 10, 2016
- Sex
- Female
- Sole proprietor
- Yes
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 | 2353-19 | WI | Primary |
Addresses
Primary practice location
831 Pine Beach Rd
Marinette, WI 54143-4225
Mailing address
7517 W Cold Spring Rd
Greenfield, WI 53220-2814
Phone (414) 327-6603
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 |
|---|---|---|---|
| 2353-19 | WI | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1462838400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1462838400000",
"number": "1124474093",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7517 W COLD SPRING RD",
"city": "GREENFIELD",
"state": "WI",
"postal_code": "532202814",
"telephone_number": "414-327-6603",
"fax_number": "414-327-5411"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "831 PINE BEACH RD",
"city": "MARINETTE",
"state": "WI",
"postal_code": "541434225",
"telephone_number": "715-732-0155"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELDRIDGE",
"first_name": "JENNIFER",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-05-10",
"last_updated": "2016-05-10",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "WI",
"license": "2353-19",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marinette, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 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.