Colleen Marie Mazza, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

3424-024 Issued in WI

Practice address

1610 Hoover St
New Holstein, WI 53061-1636

Phone

(920) 898-5627

NPI assigned

May 9, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188345600000",
    "number": "1417161464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2303 S 15TH ST",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530816240",
            "telephone_number": "920-457-6580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1610 HOOVER ST",
            "city": "NEW HOLSTEIN",
            "state": "WI",
            "postal_code": "530611636",
            "telephone_number": "920-898-5627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAZZA",
        "first_name": "COLLEEN",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-09",
        "last_updated": "2007-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "3424-024",
            "primary": true
        },
        {
            "code": "2251G0304X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Geriatrics",
            "state": "WI",
            "license": "3424-024",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "WI",
            "license": "3424-024",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40139600",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Homestead Care Center LLC (Atrium Post Acute Care of New Holstein)
• Megan Joyce Koehler, RN
• Heather Kooiman
• Sarah Mary Kraus, MS/CCC/SLP
• Amanda Jo Lanham, PA-C
• Jennifer Nadler-Lont, RN
• NSH New Holstein LLC
• NSH New Holstein-Monroe LLC (Homestead Health Services)
• Pamela Ogea, RN
• Denis J Pleviak, MD

• Physical Therapist in New Holstein, WI
• Providers in New Holstein, WI by specialty
• Physical Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 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.

Verify at the official NPI Registry.