Individual provider Active NPI

Kathleen Jo Sinclair, PT

  • Physical Therapist
  • Wauwatosa, WI
National Provider Identifier
1700034436
Registry record updated Sep 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
3662-024 Issued in WI
Practice address
2654 N 97TH St
Wauwatosa, WI 53226-1650
Phone
(414) 475-7312
NPI assigned
Sep 6, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 6, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 3662-024 WI Primary

Addresses

Primary practice location

2654 N 97TH St
Wauwatosa, WI 53226-1650

Mailing address

2654 N 97TH St
Wauwatosa, WI 53226-1650
Phone (414) 475-7312

Other identifiers 1

IdentifierTypeStateIssuer
40276400MedicaidWI

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
3662-024WIMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1220659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1220659200000",
    "number": "1700034436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2654 N 97TH ST",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532261650",
            "telephone_number": "414-475-7312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2654 N 97TH ST",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532261650",
            "telephone_number": "414-475-7312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SINCLAIR",
        "first_name": "KATHLEEN",
        "middle_name": "JO",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-06",
        "last_updated": "2008-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "3662-024",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40276400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wauwatosa, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 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.

Verify at the official NPI Registry.