Charlie Coenen

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

16719-24 Issued in WI

Practice address

6908 N Santa Monica Blvd
Fox Point, WI 53217-3942

Phone

(414) 352-2082

NPI assigned

May 27, 2024

Last updated

May 27, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Freedom Physical Therapy Services SCGroup PAC ID 8224938113, 29 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Freedom Physical Therapy Services SC

  • Physical Therapist
  • Fox Point, WI
  • NPI 1063406544
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1716768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716768000000",
    "number": "1407696677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2950 CLEARWATER LN APT 204",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531896895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6908 N SANTA MONICA BLVD",
            "city": "FOX POINT",
            "state": "WI",
            "postal_code": "532173942",
            "telephone_number": "414-352-2082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COENEN",
        "first_name": "CHARLIE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-05-27",
        "last_updated": "2024-05-27",
        "certification_date": "2024-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "16719-24",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William John Blaser, PHARMD
• Erik Kristopher Bork, DP T
• Careshare Assisted Living, Inc.
• M Sandra Casper, DDS
• Children's Medical Group
• Britt Ericka Conine, M.S., CCC-SLP
• Scott Coonen
• Emily Detsch, OD
• Eric Lewis Diamond, M.S.W., L.C.S.W.
• Jodi Fraint, OTR/L

• Physical Therapist in Fox Point, WI
• Providers in Fox Point, WI by specialty
• Physical Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.