Tera Ducommun, PTA

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

3333-19 Issued in WI

Practice address

1405 Truax Blvd
Eau Claire, WI 54703-1474

Phone

(715) 552-1030

NPI assigned

Nov 3, 2023

Last updated

Nov 3, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Tera Conwell Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1698969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1326811050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 27TH ST",
            "city": "NEW AUBURN",
            "state": "WI",
            "postal_code": "547578787",
            "telephone_number": "715-205-8746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1405 TRUAX BLVD",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547031474",
            "telephone_number": "715-552-1030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUCOMMUN",
        "first_name": "TERA",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-03",
        "last_updated": "2023-11-03",
        "certification_date": "2023-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "WI",
            "license": "3333-19",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TERA",
            "last_name": "CONWELL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Gillian Lynne Draganowski, NP
• Jonpaul Dragseth, PT, DPT
• Michael H Draper, PHARM.D
• Kaitie Dreger
• Kathryn A Dryer, MD
• Susan Marie Dudra-Guenard, COTA
• Cori Jean Duellman Wallerich, APNP
• Jarred M Duellman, MSW
• Nicholas Ethan Dull, NP
• Nicolette Dumas

• Physical Medicine & Rehabilitation Physician in Eau Claire, WI
• Providers in Eau Claire, WI by specialty
• Physical Medicine & Rehabilitation Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2023; 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.