Active NPI
Devin Freitag, PTA
- Physical Therapy Assistant
- Milwaukee, WI
National Provider Identifier
1427699677
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 2983-19
- Practice address
- 9120 W Capitol Dr
Milwaukee, WI 53222-1622 - Phone
- (414) 438-3177
- Fax
- (414) 438-3176
- NPI assigned
- Sep 30, 2019
- Sex
- Male
- 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 Therapy Assistant | 225200000X | 2983-19 | WI | Primary |
Addresses
Primary practice location
9120 W Capitol Dr
Milwaukee, WI 53222-1622
Mailing address
9120 W Capitol Dr
Milwaukee, WI 53222-1622
Phone (414) 438-3177
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2983-19 | Other | WI | WISCONSIN PTA LICENSE |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | Unknown |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2983-19 | WI | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1569801600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1569801600000",
"number": "1427699677",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9120 W CAPITOL DR",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532221622",
"telephone_number": "414-438-3177",
"fax_number": "414-438-3176"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9120 W CAPITOL DR",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532221622",
"telephone_number": "414-438-3177",
"fax_number": "414-438-3176"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FREITAG",
"first_name": "DEVIN",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-09-30",
"last_updated": "2019-09-30",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "WI",
"license": "2983-19",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WISCONSIN PTA LICENSE",
"identifier": "2983-19",
"state": "WI"
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "Unknown",
"affiliation": "N",
"address_1": "9120 W Capitol Dr",
"city": "Milwaukee",
"state": "WI",
"country_code": "US",
"postal_code": "532221622",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Milwaukee, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.