Individual provider Active NPI

Colin Michael McCready, DPT

  • Physical Therapist
  • Kenosha, WI
National Provider Identifier
1417648502
Registry record updated Sep 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT020240 Issued in OH
Practice address
3400 Market LN
Kenosha, WI 53144-3430
Phone
(262) 551-4600
NPI assigned
May 18, 2023
Last updated
Sep 25, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT020240 OH Primary

Addresses

Primary practice location

3400 Market LN
Kenosha, WI 53144-3430

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909
Phone (866) 370-8206

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, AZ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230627002912 WA Practitioner - Physical Therapist in Private Practice 6305204017 Reassigns benefits to 1 organization
I20231101000674 AZ Practitioner - Physical Therapist in Private Practice 6305204017 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Multicare Health SystemGroup PAC ID 7719899897, 2,312 clinicians

Practice addresses (Care Compare)

1423 E Main
Puyallup, WA 98372-3138
Phone (253) 697-2340

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT020240OHMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System Current Accepting new patients
Multicare Health System CurrentSince Jun 5, 2025 Accepting new patients
Ati Holdings of Arizona, LLC Physical Therapist CurrentSince Oct 2, 2023 Accepting new patients
Ideal Rehabilitation LLC PastSince Oct 2, 2023 Accepting new patients

Locations

1485 E Florence Blvd
Ste 105
Casa Grande, AZ 85122
Phone (520) 494-3058

5911 W Baseline Rd
Ste 102
Laveen, AZ 85339
Phone (480) 281-6103

11209 N Tatum Blvd
Ste B120
Phoenix, AZ 85028
Phone (602) 595-0204

1020 S Harrison Rd
Unit 120
Tucson, AZ 85748
Phone (520) 207-6288

5977 E Grant Rd
Ste 101
Tucson, AZ 85712
Phone (520) 448-5700

790 Remington Blvd
Bolingbrook, IL 60440

407 E Main St
Auburn, WA 98002
Phone (253) 545-0044

1423 E Main
Puyallup, WA 98372
Phone (253) 697-2340

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1684368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790294400000",
    "number": "1417648502",
    "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",
            "telephone_number": "866-370-8206",
            "fax_number": "517-435-3670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 MARKET LN",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531443430",
            "telephone_number": "262-551-4600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCREADY",
        "first_name": "COLIN",
        "middle_name": "MICHAEL",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-05-18",
        "last_updated": "2026-09-25",
        "certification_date": "2026-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "PT020240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kenosha, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2026; 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.