Taylor Blackman
Individual provider Active NPI Physical Therapist · New Richmond, WI
NPI 1427796010 · NPPES record last updated May 24, 2022
Key facts
- NPI
- 1427796010
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 15777-24 (WI)
- Practice address
- 471 S Arch Ave
New Richmond, WI 54017-1832 - Phone
- (715) 246-3809
- NPI assigned
- May 24, 2022
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- University of Wisconsin School of Medicine, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Dadez Physical Therapy Inc
Practice addresses (Care Compare)
471 S Arch Ave
Suite 1
New Richmond, WI 54017-1832
Phone (748) 246-3809
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220615001286 | WI | Practitioner - Physical Therapist in Private Practice | 4183003502 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dadez Physical Therapy, Inc | Current |
Accepting new patients |
Locations
471 S Arch Ave
Ste 1
New Richmond, WI 54017
Phone (715) 246-3809
471 S Arch Ave
New Richmond, WI 54017
Phone (715) 246-3809
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 15777-24 | WI | Yes |
Addresses
Primary practice location
471 S Arch Ave
New Richmond, WI 54017-1832
Mailing address
471 S Arch Ave
New Richmond, WI 54017-1832
Phone (715) 246-3809
Other names
- Taylor Leach
Other providers in New Richmond, WI
- Julie Ann Berosik
- Jessica L Bethke
- Lavanya Bhoopathy
- Christina Jean Bichner
- Holly L Bjerke
- Cynthia L Blader
- Jill M. Bladl
- Boost Home Health LLC
- Mark David Bostrom
- Conrad Christopher Botz II
All providers in New Richmond, WI · Physical Therapist in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 24, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.