Active NPI
Bethanie Head, PT, DPT
- Physical Therapist
- Pleasant Prairie, WI
National Provider Identifier
1336710995
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 6035
- Practice address
- 9809 39TH Ave
Pleasant Prairie, WI 53158-3733 - Phone
- (262) 925-5080
- NPI assigned
- Jul 6, 2021
- 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 | 6035 | OK | Primary |
Addresses
Primary practice location
9809 39TH Ave
Pleasant Prairie, WI 53158-3733
Mailing address
9809 39TH Ave Ste 2
Pleasant Prairie, WI 53158-3733
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6035 | Other | OK | PT LICENSE |
| CP043646T | Other | WI | COMPACT LICENSE |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1625529600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1747958400000",
"number": "1336710995",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9809 39TH AVE STE 2",
"city": "PLEASANT PRAIRIE",
"state": "WI",
"postal_code": "531583733"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9809 39TH AVE",
"city": "PLEASANT PRAIRIE",
"state": "WI",
"postal_code": "531583733",
"telephone_number": "262-925-5080"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HEAD",
"first_name": "BETHANIE",
"name_prefix": "Ms.",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-07-06",
"last_updated": "2025-05-23",
"certification_date": "2025-05-23",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OK",
"license": "6035",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PT LICENSE",
"identifier": "6035",
"state": "OK"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COMPACT LICENSE",
"identifier": "CP043646T",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pleasant Prairie, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.