Individual provider Active NPI

Caroline Cipriano Hanneman

  • Physical Therapist
  • Oconomowoc, WI
National Provider Identifier
1720364565
Registry record updated Oct 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1162324 Issued in WI
Practice address
2195 N Summit Village Way
Oconomowoc, WI 53066-8675
Phone
(262) 560-2426
NPI assigned
Oct 25, 2011
Last updated
Oct 25, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2011

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 1162324 WI Primary

Addresses

Primary practice location

2195 N Summit Village Way
Oconomowoc, WI 53066-8675

Mailing address

2195 N Summit Village Way
Oconomowoc, WI 53066-8675

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
1162324WIMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1319500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319500800000",
    "number": "1720364565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2195 N SUMMIT VILLAGE WAY",
            "city": "OCONOMOWOC",
            "state": "WI",
            "postal_code": "530668675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2195 N SUMMIT VILLAGE WAY",
            "city": "OCONOMOWOC",
            "state": "WI",
            "postal_code": "530668675",
            "telephone_number": "262-560-2426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CIPRIANO HANNEMAN",
        "first_name": "CAROLINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-25",
        "last_updated": "2011-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "1162324",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oconomowoc, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2011; 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.