Active NPI
Nicole Sheridan
- Physical Therapist
- Milwaukee, WI
National Provider Identifier
1225540453
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 16224-24
- Practice address
- 833 N 26TH St
Milwaukee, WI 53233-1507 - Phone
- (414) 344-7676
- NPI assigned
- Oct 27, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 2596-19 | WI | |
| Physical Therapist | 225100000X | 16224-24 | WI | Primary |
Addresses
Primary practice location
833 N 26TH St
Milwaukee, WI 53233-1507
Mailing address
833 N 26TH St
Milwaukee, WI 53233-1507
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2596-19 | WI | MD | Physical Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Penfield Children'S Center, Inc. | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Clinic/Center
- Milwaukee, WI
- NPI 1275692410
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1509062400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1694649600000",
"number": "1225540453",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "833 N 26TH ST",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532331507"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "833 N 26TH ST",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532331507",
"telephone_number": "414-344-7676"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHERIDAN",
"first_name": "NICOLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-10-27",
"last_updated": "2023-09-14",
"certification_date": "2023-09-14",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "WI",
"license": "2596-19",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WI",
"license": "16224-24",
"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 Sep 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.