Active NPI
Anne Coffman, PT
- Geriatric Physical Therapist
- Muskego, WI
National Provider Identifier
1700905809
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Geriatric Physical Therapist
- License
- 4401-024
- Practice address
- S77W12929 McShane Dr
Muskego, WI 53150-4039 - Phone
- (414) 529-0100
- NPI assigned
- Mar 28, 2007
- 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 |
|---|---|---|---|---|
| Geriatric Physical Therapist | 2251G0304X | 4401-024 | WI | Primary |
Addresses
Primary practice location
S77W12929 McShane Dr
Muskego, WI 53150-4039
Mailing address
12810 W Meadow LN
New Berlin, WI 53151-1834
Phone (262) 785-6206
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 40251000 | 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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4401-024 | WI | MD | Geriatric Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175040000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1700905809",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12810 W MEADOW LN",
"city": "NEW BERLIN",
"state": "WI",
"postal_code": "531511834",
"telephone_number": "262-785-6206"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "S77W12929 MCSHANE DR",
"city": "MUSKEGO",
"state": "WI",
"postal_code": "531504039",
"telephone_number": "414-529-0100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COFFMAN",
"first_name": "ANNE",
"name_prefix": "Ms.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-28",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2251G0304X",
"taxonomy_group": "",
"desc": "Physical Therapist, Geriatrics",
"state": "WI",
"license": "4401-024",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "40251000",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Muskego, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.