Kathleen E Beccavin, DPT
Individual provider Active NPI Physical Therapist · Elm Grove, WI
NPI 1497480347 · NPPES record last updated Jul 22, 2022
Key facts
- NPI
- 1497480347
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 16035-24 (WI)
- Practice address
- 1135 Legion Dr # 100
Elm Grove, WI 53122-2204 - Phone
- (262) 788-9578
- NPI assigned
- Jul 22, 2022
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16035-24 | WI | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Weber Physical Therapy, LLC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 16035-24 | WI | Yes |
Addresses
Primary practice location
1135 Legion Dr # 100
Elm Grove, WI 53122-2204
Mailing address
219 Lincolnshire PL Apt 207
Wales, WI 53183-8705
Phone (630) 346-3963
Other providers in Elm Grove, WI
- Leanna Barr
- Diane Marie Bast
- Natasha Basu
- Susan Baumann
- Margaret Marie Bayer
- Morgan Becker
- Helen Berger
- Laura Beschta
- Megan Bielinski
- Laura Beth Biwer
All providers in Elm Grove, 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 Jul 22, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.