Active NPI
Kristine C. Dekarske, P.T.
- Physical Therapist
- Burlington, WI
National Provider Identifier
1578725628
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1045-024
- Practice address
- 677 E State St
Burlington, WI 53105-1639 - Phone
- (262) 763-9531
- Fax
- (262) 763-7579
- NPI assigned
- Jun 30, 2008
- 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 Therapist | 225100000X | 1045-024 | WI | Primary |
Addresses
Primary practice location
677 E State St
Burlington, WI 53105-1639
Mailing address
677 E State St
Burlington, WI 53105-1639
Phone (262) 763-9531
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 40019700 | Medicaid | WI |
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 |
|---|---|---|---|
| 1045-024 | WI | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1214784000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1214784000000",
"number": "1578725628",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "677 E STATE ST",
"city": "BURLINGTON",
"state": "WI",
"postal_code": "531051639",
"telephone_number": "262-763-9531",
"fax_number": "262-763-7579"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "677 E STATE ST",
"city": "BURLINGTON",
"state": "WI",
"postal_code": "531051639",
"telephone_number": "262-763-9531",
"fax_number": "262-763-7579"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEKARSKE",
"first_name": "KRISTINE",
"middle_name": "C.",
"name_prefix": "Mrs.",
"credential": "P.T.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-06-30",
"last_updated": "2008-06-30",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WI",
"license": "1045-024",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "40019700",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Burlington, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.