Individual provider Active NPI

Kate Jahnz, PTA

  • Physical Therapy Assistant
  • Brookfield, WI
National Provider Identifier
1588399794
Registry record updated Sep 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
2978-19 Issued in WI
Practice address
3360 Gateway Rd Ste 100
Brookfield, WI 53045-5115
Phone
(262) 923-7101
NPI assigned
Jul 21, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2022

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 2978-19 WI Primary

Addresses

Primary practice location

3360 Gateway Rd Ste 100
Brookfield, WI 53045-5115

Mailing address

1516 N 19TH St
Sheboygan, WI 53081-2319
Phone (920) 287-2199

Other practice location 1

1516 N 19th St
Sheboygan, WI 53081-2319
Phone (920) 287-2199

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
2978-19WIMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Greenfield Rehabilitation Agency, Inc. CurrentSince Sep 25, 2022 Accepting new patients
Greenfield Rehabilitation Agency, Inc. CurrentSince Sep 25, 2022 Accepting new patients

Locations

3360 Gateway Rd
Ste 100
Brookfield, WI 53045
Phone (262) 295-6289

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1658361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663545600000",
    "number": "1588399794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1516 N 19TH ST",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530812319",
            "telephone_number": "920-287-2199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3360 GATEWAY RD STE 100",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530455115",
            "telephone_number": "262-923-7101"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1516 N 19th St",
            "address_purpose": "LOCATION",
            "city": "Sheboygan",
            "state": "WI",
            "postal_code": "530812319",
            "country_code": "US",
            "telephone_number": "920-287-2199",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JAHNZ",
        "first_name": "KATE",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-21",
        "last_updated": "2022-09-19",
        "certification_date": "2022-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WI",
            "license": "2978-19",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookfield, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2022; 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.