Individual provider Active NPI

Ulma Anclam, PTA

  • Physical Therapy Assistant
  • Darien, WI
National Provider Identifier
1285032664
Registry record updated Dec 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
2233-19 Issued in WI
Practice address
13113 E Creek Rd
Darien, WI 53114-1127
Phone
(262) 882-5481
NPI assigned
Dec 16, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2014

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 2233-19 WI Primary

Addresses

Primary practice location

13113 E Creek Rd
Darien, WI 53114-1127

Mailing address

13113 E Creek Rd
Darien, WI 53114-1127
Phone (262) 882-5481

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
2233-19WIMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1418688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418688000000",
    "number": "1285032664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13113 E CREEK RD",
            "city": "DARIEN",
            "state": "WI",
            "postal_code": "531141127",
            "telephone_number": "262-882-5481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13113 E CREEK RD",
            "city": "DARIEN",
            "state": "WI",
            "postal_code": "531141127",
            "telephone_number": "262-882-5481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANCLAM",
        "first_name": "ULMA",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-16",
        "last_updated": "2014-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WI",
            "license": "2233-19",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Darien, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2014; 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.