Individual provider Active NPI

Nicola Deacon, DPT

  • Physical Therapist
  • Franklin, WI
National Provider Identifier
1235330341
Registry record updated Oct 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
10280-024 Issued in WI
Practice address
9120 W Loomis Rd Ste 100
Franklin, WI 53132-9083
Phone
(414) 858-1740
NPI assigned
May 29, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2023

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 10280-024 WI Primary

Addresses

Primary practice location

9120 W Loomis Rd Ste 100
Franklin, WI 53132-9083

Mailing address

PO Box 735044
Chicago, IL 60673-5044

Other practice location 1

5000 W Chambers St
Milwaukee, WI 53210-1650
Phone (414) 447-2209

Other identifiers 1

IdentifierTypeStateIssuer
100071975MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address ndeacon359342@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091120000541 WI Practitioner - Physical Therapist in Private Practice 6406995067 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aurora Advanced Healthcare, Inc.Group PAC ID 3375625833, 1,107 clinicians

Practice addresses (Care Compare)

3003 W Good Hope Rd
Milwaukee, WI 53209-2042
Phone (414) 352-3100

9200 W Loomis Rd
Franklin, WI 53132-8887
Phone (414) 529-9200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10280-024WIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Advanced Healthcare Inc CurrentSince Jan 16, 2023 Accepting new patients
Aurora Advanced Healthcare, Inc. CurrentSince Jan 16, 2023 Accepting new patients

Locations

9120 W Loomis Rd
Ste 100
Franklin, WI 53132
Phone (262) 939-9318

3003 W Good Hope Rd
Glendale, WI 53209
Phone (414) 352-3100

12203 N Corporate Pkwy
Mequon, WI 53092
Phone (262) 387-8200

3301 W Forest Home Ave
Milwaukee, WI 53215
Phone (414) 389-2233

5000 W Chambers St
Milwaukee, WI 53210
Phone (414) 447-2089

Interoperability endpoints

  • Direct secure messaging: ndeacon359342@direct.myadvocateaurora.org

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1180396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697155200000",
    "number": "1235330341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735044",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606735044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9120 W LOOMIS RD STE 100",
            "city": "FRANKLIN",
            "state": "WI",
            "postal_code": "531329083",
            "telephone_number": "414-858-1740"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5000 W Chambers St",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532101650",
            "country_code": "US",
            "telephone_number": "414-447-2209",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEACON",
        "first_name": "NICOLA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-29",
        "last_updated": "2023-10-13",
        "certification_date": "2023-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "10280-024",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100071975",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ndeacon359342@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "5000 W Chambers St",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532101650",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "5000 W Chambers St",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532101650",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Franklin, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.