Active NPI
Cynthia Ann Pickworth
- Physical Therapist
- De Pere, WI
National Provider Identifier
1275700668
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 10894-024
- Practice address
- 200 S 9TH St
De Pere, WI 54115-1393 - Phone
- (920) 632-4885
- NPI assigned
- May 14, 2008
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 10894-024 | WI | Primary |
Addresses
Primary practice location
200 S 9TH St
De Pere, WI 54115-1393
Mailing address
1395 Bingham Dr
De Pere, WI 54115-4063
Phone (920) 632-4885
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
| License | State | Type | Specialty |
|---|---|---|---|
| 10894-024 | WI | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1210723200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1210723200000",
"number": "1275700668",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1395 BINGHAM DR",
"city": "DE PERE",
"state": "WI",
"postal_code": "541154063",
"telephone_number": "920-632-4885"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 S 9TH ST",
"city": "DE PERE",
"state": "WI",
"postal_code": "541151393",
"telephone_number": "920-632-4885"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PICKWORTH",
"first_name": "CYNTHIA",
"middle_name": "ANN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-05-14",
"last_updated": "2008-05-14",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WI",
"license": "10894-024",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in De Pere, 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.