Mitchell Paddock, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

4439024 Issued in WI

Practice address

9632 W Appleton Ave
Milwaukee, WI 53225-3305

Phone

(414) 535-6704

Fax

(414) 535-6952

NPI assigned

Aug 20, 2007

Last updated

Aug 20, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1187568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187568000000",
    "number": "1184817603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9632 W APPLETON AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532253305",
            "telephone_number": "414-535-6704",
            "fax_number": "414-535-6952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9632 W APPLETON AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532253305",
            "telephone_number": "414-535-6704",
            "fax_number": "414-535-6952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PADDOCK",
        "first_name": "MITCHELL",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-20",
        "last_updated": "2007-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "4439024",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40292500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emilee Kae Packee, APNP
• Rachel Marie Packee, LPC-SASD
• Kevin Scott Packman, MD
• Sarah Packman, APNP
• Kiran K Padala, MD
• Aasim Ilyas Padela, MD
• Dawn Janeen Padilla, RN
• Noelia Cristina Padilla
• Padre Pio Pediatrics LLC
• Luisa Ivellisse Padron, RADC I

• Physical Therapist in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Physical Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 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.