Active NPI
Anne Kollmann
- Physical Therapy Assistant
- Fond Du Lac, WI
National Provider Identifier
1649647017
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 2362-19
- Practice address
- 115 E Arndt St # 907
Fond Du Lac, WI 54935-2461 - Phone
- (920) 907-0263
- NPI assigned
- Sep 1, 2015
- Sex
- Female
- Sole proprietor
- No
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 | 2362-19 | WI | Primary |
Addresses
Primary practice location
115 E Arndt St # 907
Fond Du Lac, WI 54935-2461
Mailing address
115 E Arndt St # 907
Fond Du Lac, WI 54935-2461
Phone (920) 907-0263
Other names 1
- Anne Marie Rodenkirch
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 |
|---|---|---|---|
| 2362-19 | WI | MD | Physical Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| FMG Mead Avenue Wisconsin LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
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- NPI 1881083228
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1441065600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1441065600000",
"number": "1649647017",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "115 E ARNDT ST # 907",
"city": "FOND DU LAC",
"state": "WI",
"postal_code": "549352461",
"telephone_number": "920-907-0263"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "115 E ARNDT ST # 907",
"city": "FOND DU LAC",
"state": "WI",
"postal_code": "549352461",
"telephone_number": "920-907-0263"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOLLMANN",
"first_name": "ANNE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-09-01",
"last_updated": "2015-09-01",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "WI",
"license": "2362-19",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "ANNE",
"last_name": "RODENKIRCH",
"middle_name": "MARIE",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Fond Du Lac, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.