Individual provider Active NPI

Constance Salm, PTA

  • Physical Therapy Assistant
  • Sheboygan, WI
National Provider Identifier
1568911956
Registry record updated Sep 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
2529 Issued in WI
Practice address
1902 Mead Ave
Sheboygan, WI 53081-6140
Phone
(920) 458-8333
NPI assigned
Sep 26, 2016
Last updated
Sep 26, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 2529 WI Primary

Addresses

Primary practice location

1902 Mead Ave
Sheboygan, WI 53081-6140

Mailing address

600 James St
Apt 208
De Pere, WI 54115-2855
Phone (920) 242-3737

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

LicenseStateTypeSpecialty
2529WIMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1474848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474848000000",
    "number": "1568911956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 JAMES ST",
            "address_2": "APT 208",
            "city": "DE PERE",
            "state": "WI",
            "postal_code": "541152855",
            "telephone_number": "920-242-3737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1902 MEAD AVE",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530816140",
            "telephone_number": "920-458-8333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALM",
        "first_name": "CONSTANCE",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-26",
        "last_updated": "2016-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WI",
            "license": "2529",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sheboygan, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.