Individual provider Active NPI

Elisabeth Magnus, PT

  • Physical Therapist
  • Elm Grove, WI
National Provider Identifier
1154765303
Registry record updated Apr 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
4387-24 Issued in WI
Practice address
13105 Watertown Plank Rd
Elm Grove, WI 53122-2213
Phone
(262) 787-1375
NPI assigned
Apr 18, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2013

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 4387-24 WI Primary

Addresses

Primary practice location

13105 Watertown Plank Rd
Elm Grove, WI 53122-2213

Mailing address

13105 Watertown Plank Rd
Elm Grove, WI 53122-2213
Phone (262) 787-1375

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

State licenses

LicenseStateTypeSpecialty
4387-24WIMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1366243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366243200000",
    "number": "1154765303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13105 WATERTOWN PLANK RD",
            "city": "ELM GROVE",
            "state": "WI",
            "postal_code": "531222213",
            "telephone_number": "262-787-1375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13105 WATERTOWN PLANK RD",
            "city": "ELM GROVE",
            "state": "WI",
            "postal_code": "531222213",
            "telephone_number": "262-787-1375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAGNUS",
        "first_name": "ELISABETH",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-18",
        "last_updated": "2013-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "4387-24",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elm Grove, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2013; 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.