NPIMap

Organization Active NPI

M & M Physical Therapy, LLC

  • Physical Therapist
  • South Milwaukee, WI
National Provider Identifier
1235222746
Registry record updated Mar 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5437 Issued in WI
Legal business name
M & M PHYSICAL THERAPY, LLC
Practice address
1333 College Ave
Suite B
South Milwaukee, WI 53172
Phone
(414) 571-9146
Fax
(414) 571-9147
NPI assigned
Oct 2, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2008

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

Authorized official

Name
Mrs. Melissa D Martin, PTNPI 1578565388
Title
Owner
Phone
(414) 571-9146

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225100000X 5437 WI Primary
Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225100000X 5672 WI

Addresses

Primary practice location

1333 College Ave
Suite B
South Milwaukee, WI 53172

Mailing address

1333 College Ave
Suite B
South Milwaukee, WI 53172
Phone (414) 571-9146

Other identifiers 1

IdentifierTypeStateIssuer
40355700MedicaidWI

National Provider Directory

National Provider Directory

Locations

1333 College Ave
Ste B
South Milwaukee, WI 53172
Phone (414) 571-9146

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205193600000",
    "number": "1235222746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1333 COLLEGE AVE",
            "address_2": "SUITE B",
            "city": "SOUTH MILWAUKEE",
            "state": "WI",
            "postal_code": "53172",
            "telephone_number": "414-571-9146",
            "fax_number": "414-571-9147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1333 COLLEGE AVE",
            "address_2": "SUITE B",
            "city": "SOUTH MILWAUKEE",
            "state": "WI",
            "postal_code": "53172",
            "telephone_number": "414-571-9146",
            "fax_number": "414-571-9147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "M & M PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-02",
        "last_updated": "2008-03-11",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "414-571-9146",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "5437",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "5672",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40355700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 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.