Active NPI
Bonnie Murphy, PTA
- Physical Therapy Assistant
- Milwaukee, WI
National Provider Identifier
1437362613
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 796-019
- Practice address
- 2448 S 102ND St
Milwaukee, WI 53227-2466 - Phone
- (414) 510-8107
- NPI assigned
- May 7, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Medicine & Rehabilitation Physician | 208100000X | 796-19 | WI | |
| Physical Therapy Assistant | 225200000X | 796-19 | WI | |
| Physical Therapy Assistant | 225200000X | 796-019 | WI | Primary |
Addresses
Primary practice location
2448 S 102ND St
Milwaukee, WI 53227-2466
Mailing address
17725 W Observatory Rd
New Berlin, WI 53146-3237
Phone (414) 510-0844
Other practice location 1
3821 S Chicago Ave
South Milwaukee, WI 53172-3712
Phone (414) 762-6379
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437362613 | Medicaid | WI |
Other names 1
- Bonnie Fatemi
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 |
|---|---|---|---|
| 796-19 | WI | MD | Physical Medicine & Rehabilitation Physician |
| 796-019 | WI | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178496000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1551916800000",
"number": "1437362613",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17725 W OBSERVATORY RD",
"city": "NEW BERLIN",
"state": "WI",
"postal_code": "531463237",
"telephone_number": "414-510-0844"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2448 S 102ND ST",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532272466",
"telephone_number": "414-510-8107"
}
],
"practiceLocations": [
{
"address_1": "3821 S Chicago Ave",
"address_purpose": "LOCATION",
"city": "South Milwaukee",
"state": "WI",
"postal_code": "531723712",
"country_code": "US",
"telephone_number": "414-762-6379",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MURPHY",
"first_name": "BONNIE",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-07",
"last_updated": "2019-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "208100000X",
"taxonomy_group": "",
"desc": "Physical Medicine & Rehabilitation",
"state": "WI",
"license": "796-19",
"primary": false
},
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "WI",
"license": "796-19",
"primary": false
},
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "WI",
"license": "796-019",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1437362613",
"state": "WI"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "BONNIE",
"last_name": "FATEMI",
"credential": "PTA",
"code": "1",
"type": "Former Name"
}
]
}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 Mar 7, 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.