Active NPI
Donna A Rosenberg, PTA
- Physical Therapy Assistant
- Mequon, WI
National Provider Identifier
1497781728
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 54-019
- Practice address
- 13111 N Port Washington Rd
Mequon, WI 53097-2416 - Phone
- (262) 243-7444
- NPI assigned
- Jun 26, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 54-019 | WI | Primary |
Addresses
Primary practice location
13111 N Port Washington Rd
Mequon, WI 53097-2416
Mailing address
746 Lakefield Rd
Grafton, WI 53024-9722
Phone (262) 375-6254
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 |
|---|---|---|---|
| 54-019 | WI | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151280000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1497781728",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "746 LAKEFIELD RD",
"city": "GRAFTON",
"state": "WI",
"postal_code": "530249722",
"telephone_number": "262-375-6254"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13111 N PORT WASHINGTON RD",
"city": "MEQUON",
"state": "WI",
"postal_code": "530972416",
"telephone_number": "262-243-7444"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSENBERG",
"first_name": "DONNA",
"middle_name": "A",
"credential": "PTA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-06-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "WI",
"license": "54-019",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mequon, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.