Nicole L Valk

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5064-024 Issued in WI

Practice address

250 W Coventry CT
Suite 204
Glendale, WI 53217-3972

Phone

(414) 228-7900

Fax

(414) 228-7901

NPI assigned

Jul 14, 2006

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 identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Active Care Rehab, S.C.

  • Physical Therapist
  • Glendale, WI
  • NPI 1023041381
  NPD (past)
• Lakeshore Medical Clinic, LLC

  • Family Medicine Physician
  • Saint Francis, WI
  • NPI 1003861188

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200268800000",
    "number": "1346266178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2656 N 63RD ST",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532131550",
            "telephone_number": "262-240-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 W COVENTRY CT",
            "address_2": "SUITE 204",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "532173972",
            "telephone_number": "414-228-7900",
            "fax_number": "414-228-7901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALK",
        "first_name": "NICOLE",
        "middle_name": "L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-14",
        "last_updated": "2008-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "5064-024",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40307400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maryam Tunio, DDS
• Artie Junior Turner
• Margo Ann Turner, M.S./CCC-SLP
• Ryan Michael Ungerecht, PT, DPT
• Frank Paul Urtz, PHD
• Patricia M. Van Den Kieboom, OTR
• Danielle Van Dyck, DPT
• Allen D Van Scoyk, D.C.
• Ilva E Van Valkenburgh, MD
• Frederick Jacobus Van Vuuren

• Physical Therapist in Glendale, WI
• Providers in Glendale, WI by specialty
• Physical Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2008; 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.