NPIMap

Organization Active NPI

Milwaukee Advanced Physical Therapy, LLC

  • Physical Therapist
  • Milwaukee, WI
National Provider Identifier
1316569692
Registry record updated May 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
MILWAUKEE ADVANCED PHYSICAL THERAPY, LLC
Practice address
1626 W Fond Du Lac Ave
Milwaukee, WI 53205-1228
Phone
(414) 436-5155
NPI assigned
May 10, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 10, 2020

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

Authorized official

Name
Mr. Santana Deacon, PTNPI 1568632818
Title
Physical Therapist/Co Owner
Phone
(414) 517-6585

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

1626 W Fond Du Lac Ave
Milwaukee, WI 53205-1228

Mailing address

1626 W Fond Du Lac Ave
Milwaukee, WI 53205-1228

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1589068800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1589068800000",
    "number": "1316569692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1626 W FOND DU LAC AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532051228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1626 W FOND DU LAC AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532051228",
            "telephone_number": "414-436-5155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILWAUKEE ADVANCED PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-10",
        "last_updated": "2020-05-10",
        "certification_date": "2020-05-10",
        "status": "A",
        "authorized_official_last_name": "DEACON",
        "authorized_official_first_name": "SANTANA",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST/CO OWNER",
        "authorized_official_telephone_number": "414-517-6585",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2020; 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.