Daniel James Cresco, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

3186 Issued in WI

Practice address

1126 S 70TH St
Suite S305B
West Allis, WI 53214-3151

Phone

(414) 456-2332

Fax

(414) 456-2339

NPI assigned

May 14, 2008

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)

Not enrolled

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

{
    "created_epoch": "1210723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210723200000",
    "number": "1215104567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1126 S 70TH ST",
            "address_2": "SUITE S305B",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532143151",
            "telephone_number": "414-456-2332",
            "fax_number": "414-456-2339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1126 S 70TH ST",
            "address_2": "SUITE S305B",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532143151",
            "telephone_number": "414-456-2332",
            "fax_number": "414-456-2339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRESCO",
        "first_name": "DANIEL",
        "middle_name": "JAMES",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-14",
        "last_updated": "2008-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "3186",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40107700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in West Allis, WI
• Providers in West Allis, WI by specialty
• Physical Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2008; 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.