Selena Kim Fraki-Owen, MSPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501011985 Issued in MI

Practice address

1100 Gateway Court
West Bend, WI 53095

Phone

(262) 306-6100

Fax

(262) 306-6105

NPI assigned

Mar 16, 2006

Last updated

Oct 21, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: sfrakiowen13556@direct.myadvocateaurora.org

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1142467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729468800000",
    "number": "1558330951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 GATEWAY COURT",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "53095",
            "telephone_number": "262-306-6100",
            "fax_number": "262-306-6105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 GATEWAY COURT",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "53095",
            "telephone_number": "262-306-6100",
            "fax_number": "262-306-6105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRAKI-OWEN",
        "first_name": "SELENA",
        "middle_name": "KIM",
        "name_prefix": "Mrs.",
        "credential": "MSPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-03-16",
        "last_updated": "2024-10-21",
        "certification_date": "2024-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501011985",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "36133700",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sfrakiowen13556@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1100 Gateway Court",
            "city": "West Bend",
            "state": "WI",
            "country_code": "US",
            "postal_code": "53095",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "1100 Gateway Court",
            "city": "West Bend",
            "state": "WI",
            "country_code": "US",
            "postal_code": "53095",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Physical Therapist in West Bend, WI
• Providers in West Bend, WI by specialty
• Physical Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.