Individual provider Active NPI

Michelle Dorann Hahn, PTA

  • Physical Therapy Assistant
  • Lake Mills, WI
National Provider Identifier
1255508024
Registry record updated May 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
422-019 Issued in WI
Practice address
W8248 Bridle Path
Lake Mills, WI 53551-9417
Phone
(920) 645-0068
NPI assigned
May 12, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 422-019 WI Primary

Addresses

Primary practice location

W8248 Bridle Path
Lake Mills, WI 53551-9417

Mailing address

W8248 Bridle Path
Lake Mills, WI 53551-9417
Phone (920) 645-0068

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
422-019WIMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1210550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210723200000",
    "number": "1255508024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W8248 BRIDLE PATH",
            "city": "LAKE MILLS",
            "state": "WI",
            "postal_code": "535519417",
            "telephone_number": "920-645-0068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W8248 BRIDLE PATH",
            "city": "LAKE MILLS",
            "state": "WI",
            "postal_code": "535519417",
            "telephone_number": "920-645-0068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAHN",
        "first_name": "MICHELLE",
        "middle_name": "DORANN",
        "name_prefix": "Mrs.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-12",
        "last_updated": "2008-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WI",
            "license": "422-019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Mills, WI

Sources for this page

  • 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.