Individual provider Active NPI

Kathryn Molitor Simon, PT

  • Physical Therapist
  • Mequon, WI
National Provider Identifier
1700322237
Registry record updated Jan 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2439-24 Issued in WI
Practice address
1249 W Liebau Rd
Mequon, WI 53092-3396
Phone
(262) 243-4161
Fax
(262) 243-4166
NPI assigned
Jan 8, 2017
Last updated
Jan 8, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 8, 2017

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 2439-24 WI Primary

Addresses

Primary practice location

1249 W Liebau Rd
Mequon, WI 53092-3396

Mailing address

1249 W Liebau Rd
Mequon, WI 53092-3396
Phone (262) 243-4161

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
2439-24WIMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1483833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483833600000",
    "number": "1700322237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1249 W LIEBAU RD",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530923396",
            "telephone_number": "262-243-4161",
            "fax_number": "262-243-4166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1249 W LIEBAU RD",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530923396",
            "telephone_number": "262-243-4161",
            "fax_number": "262-243-4166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMON",
        "first_name": "KATHRYN",
        "middle_name": "MOLITOR",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-01-08",
        "last_updated": "2017-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "2439-24",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mequon, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2017; 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.