Individual provider Active NPI

Devin Freitag, PTA

  • Physical Therapy Assistant
  • Milwaukee, WI
National Provider Identifier
1427699677
Registry record updated Sep 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
2983-19 Issued in WI
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

Updated by the provider on Sep 30, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
2983-19OtherWIWISCONSIN PTA LICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
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

LicenseStateTypeSpecialty
2983-19WIMDPhysical 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.

Verify at the official NPI Registry.