Individual provider Active NPI

Karen Cole Gottschalk, PT

  • Physical Therapist
  • Kenosha, WI
National Provider Identifier
1316166606
Registry record updated Jun 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
148464-24 Issued in WI
Practice address
7610 Pershing Blvd
Kenosha, WI 53142-4318
Phone
(262) 948-3600
NPI assigned
Apr 25, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 6, 2024

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 148464-24 WI Primary

Addresses

Primary practice location

7610 Pershing Blvd
Kenosha, WI 53142-4318

Mailing address

PO Box 735041
Chicago, IL 60673-5041
Phone (800) 326-2250

Other identifiers 2

IdentifierTypeStateIssuer
100140484MedicaidWI
14864-24OtherWIWISCONSIN DEPARTMENT OF SAFETY AND PROFESSIONAL SERVICES

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address karengottschalkpt@hushmail.com Health Information Exchange (HIE)

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
148464-24WIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Health Care Southern Lakes, Inc. PastSince Jun 9, 2024 Accepting new patients
Integrated Clinix Physical Therapist PastSince Oct 1, 2022 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": "1177459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717632000000",
    "number": "1316166606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735041",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606735041",
            "telephone_number": "800-326-2250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7610 PERSHING BLVD",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531424318",
            "telephone_number": "262-948-3600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOTTSCHALK",
        "first_name": "KAREN",
        "middle_name": "COLE",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-25",
        "last_updated": "2024-06-06",
        "certification_date": "2024-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "148464-24",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100140484",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WISCONSIN DEPARTMENT OF SAFETY AND PROFESSIONAL SERVICES",
            "identifier": "14864-24",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "karengottschalkpt@hushmail.com",
            "affiliation": "N",
            "endpointDescription": "encrypted e-mail",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "202 W Summerhill Pl",
            "city": "Oak Creek",
            "state": "WI",
            "country_code": "US",
            "postal_code": "531545035",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kenosha, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2024; 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.