Individual provider Active NPI

Denise Susan McCormick, D-PT

  • Physical Therapist
  • Oconto, WI
National Provider Identifier
1720723646
Registry record updated Jul 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
15769-24 Issued in WI
Practice address
820 Arbutus Ave
Oconto, WI 54153-2004
Phone
(920) 835-1100
Fax
(920) 835-1099
NPI assigned
May 4, 2022
Last updated
Jul 8, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2026

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 15769-24 WI Primary

Addresses

Primary practice location

820 Arbutus Ave
Oconto, WI 54153-2004

Mailing address

PO Box 735044
Chicago, IL 60673-5044
Phone (800) 326-2250

Other practice location 1

744 S Webster Ave
Green Bay, WI 54301-3505
Phone (920) 433-3500

Other identifiers 1

IdentifierTypeStateIssuer
100200277MedicaidWI

Other names 1

  • Denise Susan Coppock Former name

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/
Direct Messaging Address dcoppock393327@direct.myadvocateaurora.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220517000669 WI Practitioner - Physical Therapist in Private Practice 7618354481 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
15769-24WIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Bellin Memorial Hospital Inc Physical Therapist CurrentSince May 5, 2022 Accepting new patients
Oconto Hospital & Medical Center Inc CurrentSince May 5, 2022 Accepting new patients
Oconto Hospital & Medical Center Inc Current Accepting new patients
Oconto Hospital & Medical Center, Inc. CurrentSince May 5, 2022 Accepting new patients
Bellin Memorial Hospital Inc Current Accepting new patients

Locations

3263 Eaton Rd
Green Bay, WI 54311
Phone (920) 433-6000

744 S Webster Ave
Green Bay, WI 54301
Phone (920) 433-6025

820 Arbutus Ave
Oconto, WI 54153
Phone (920) 835-1100

107 E Highland Dr
Oconto Falls, WI 54154
Phone (920) 846-0509

Interoperability endpoints

  • Direct secure messaging: dcoppock393327@direct.myadvocateaurora.org

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1651622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783468800000",
    "number": "1720723646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735044",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606735044",
            "telephone_number": "800-326-2250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 ARBUTUS AVE",
            "city": "OCONTO",
            "state": "WI",
            "postal_code": "541532004",
            "telephone_number": "920-835-1100",
            "fax_number": "920-835-1099"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "744 S Webster Ave",
            "address_purpose": "LOCATION",
            "city": "Green Bay",
            "state": "WI",
            "postal_code": "543013505",
            "country_code": "US",
            "telephone_number": "920-433-3500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCCORMICK",
        "first_name": "DENISE",
        "middle_name": "SUSAN",
        "credential": "D-PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-04",
        "last_updated": "2026-07-08",
        "certification_date": "2026-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "15769-24",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100200277",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "744 S Webster Ave",
            "city": "Green Bay",
            "state": "WI",
            "country_code": "US",
            "postal_code": "543013505",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dcoppock393327@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "744 S Webster Ave",
            "city": "Green Bay",
            "state": "WI",
            "country_code": "US",
            "postal_code": "543013505",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "DENISE",
            "last_name": "COPPOCK",
            "middle_name": "SUSAN",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Oconto, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.