Amy C Truog, DPT
Individual provider Active NPI Physical Therapist · Jackson, WI
NPI 1487260774 · NPPES record last updated Sep 22, 2020
Key facts
- NPI
- 1487260774
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 12158 (WI)
- Practice address
- W227N16857 Tillie Lake CT
Jackson, WI 53037-9000 - Phone
- (262) 365-6170
- NPI assigned
- Sep 22, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 14
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Froedtert Andthe Medical College of Wisconsin Community Physicians Inc
Practice addresses (Care Compare)
1700 W Paradise Dr
West Bend, WI 53095-9795
Phone (262) 334-3451
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20201117001477 | WI | Practitioner - Physical Therapist in Private Practice | 7719398007 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12158 | WI | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Froedtert &the Medical College of Wisconsin Community Physicians, Inc. | Current |
Accepting new patients | |
| Froedtert &the Medical College of Wisconsin Community Physicians, Inc. | Current |
Accepting new patients |
Locations
W168N11237 Western Ave
Germantown, WI 53022
Phone (262) 253-5060
W225N16711 Cedar Park Ct
Jackson, WI 53037
Phone (262) 323-9257
W227N16857 Tillie Lake Ct
Jackson, WI 53037
Phone (262) 365-6170
1155 N Mayfair Rd
Wauwatosa, WI 53226
Phone (414) 955-5990
1700 W Paradise Dr
West Bend, WI 53095
Phone (262) 334-3451
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 12158 | WI | Yes |
Addresses
Primary practice location
W227N16857 Tillie Lake CT
Jackson, WI 53037-9000
Mailing address
612 Eastern Ave
West Bend, WI 53095-4114
Phone (217) 306-4864
Other names
- Amy C Waters
Other providers in Jackson, WI
- Laura Jean Steinmetz
- Samuel R Stevens
- Rachel Telschow
- The Lactation Network, LLC
- Jennifer Lynn Thompson
- Marc A Vaughan
- Village of Jackson
- Village of Jackson
- Paulet J. Voigt
- Walgreen Co
All providers in Jackson, 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 Sep 22, 2020. 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.