Active NPI
Tiffany Legate
- Physical Therapist
- West Bend, WI
National Provider Identifier
1396223061
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Practice address
- 1769 S Main St
West Bend, WI 53095-4937 - Phone
- (262) 438-9943
- NPI assigned
- Aug 3, 2018
- Last updated
- Aug 3, 2018
- 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 | NU | Primary |
Addresses
Primary practice location
1769 S Main St
West Bend, WI 53095-4937
Mailing address
790 Remington Blvd
Bolingbrook, IL 60440-4909
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": "1533254400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1533254400000",
"number": "1396223061",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "790 REMINGTON BLVD",
"city": "BOLINGBROOK",
"state": "IL",
"postal_code": "604404909"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1769 S MAIN ST",
"city": "WEST BEND",
"state": "WI",
"postal_code": "530954937",
"telephone_number": "262-438-9943"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEGATE",
"first_name": "TIFFANY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-08-03",
"last_updated": "2018-08-03",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Bend, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.