Individual provider Active NPI

Amie C Hoagland, P.T.

  • Physical Therapist
  • Racine, WI
National Provider Identifier
1255318226
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
9743-024 Issued in WI
Practice address
4214 Sheridan Rd
Racine, WI 53403-4142
Phone
(262) 554-6515
Fax
(262) 554-6892
NPI assigned
Dec 29, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 9743-024 WI Primary

Addresses

Primary practice location

4214 Sheridan Rd
Racine, WI 53403-4142

Mailing address

N72W16078 Good Hope Rd
Menomonee Falls, WI 53051-4552
Phone (262) 502-1844

Other identifiers 1

IdentifierTypeStateIssuer
40359200MedicaidWI

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

LicenseStateTypeSpecialty
9743-024WIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Racine County Opportunity Center, Inc. Past Accepting new patients
Easter Seals Southeast Wisconsin Physical Therapist Past Accepting new patients

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": "1135814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1255318226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N72W16078 GOOD HOPE RD",
            "city": "MENOMONEE FALLS",
            "state": "WI",
            "postal_code": "530514552",
            "telephone_number": "262-502-1844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4214 SHERIDAN RD",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534034142",
            "telephone_number": "262-554-6515",
            "fax_number": "262-554-6892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOAGLAND",
        "first_name": "AMIE",
        "middle_name": "C",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "9743-024",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40359200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Racine, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.