Active NPI
Annette M Hart, PT
- Physical Therapist
- Winnebago, WI
National Provider Identifier
1346453115
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1566 024
- Practice address
- 725 Butler Ave
Parkview Health Care Center
Winnebago, WI 54985-0010 - Phone
- (920) 235-5100
- NPI assigned
- May 8, 2007
- 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 | 1566 024 | WI | Primary |
Addresses
Primary practice location
725 Butler Ave
Parkview Health Care Center
Winnebago, WI 54985-0010
Mailing address
603 N Nash St
Hortonville, WI 54944
Phone (920) 779-0285
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 401653 | Medicaid | WI |
Other names 1
- Ms. Annette M Johnson
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1566 024 | WI | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178582400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1346453115",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "603 N NASH ST",
"city": "HORTONVILLE",
"state": "WI",
"postal_code": "54944",
"telephone_number": "920-779-0285"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "725 BUTLER AVE",
"address_2": "PARKVIEW HEALTH CARE CENTER",
"city": "WINNEBAGO",
"state": "WI",
"postal_code": "549850010",
"telephone_number": "920-235-5100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HART",
"first_name": "ANNETTE",
"middle_name": "M",
"name_prefix": "Ms.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-08",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WI",
"license": "1566 024",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "401653",
"state": "WI"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "ANNETTE",
"last_name": "JOHNSON",
"middle_name": "M",
"prefix": "MS.",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Winnebago, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.