Individual provider Active NPI

Adrian Elinge Kange, PTA,CPT

  • Physical Therapy Assistant
  • Glendale, WI
National Provider Identifier
1750154134
Registry record updated Nov 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
4061 Issued in WI
Practice address
1300 W Silver Spring Dr
Glendale, WI 53209-4415
Phone
(414) 228-8120
NPI assigned
Nov 6, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X A2871 MN
Physical Therapy Assistant 225200000X 4061 WI Primary

Addresses

Primary practice location

1300 W Silver Spring Dr
Glendale, WI 53209-4415

Mailing address

N168W21850 Main St Apt 39
Jackson, WI 53037-9395
Phone (612) 242-6173

Other names 1

  • Adrian Elinge Kange Professional name

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
A2871MNMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1699228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699228800000",
    "number": "1750154134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N168W21850 MAIN ST APT 39",
            "city": "JACKSON",
            "state": "WI",
            "postal_code": "530379395",
            "telephone_number": "612-242-6173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 W SILVER SPRING DR",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "532094415",
            "telephone_number": "414-228-8120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANGE",
        "first_name": "ADRIAN",
        "middle_name": "ELINGE",
        "credential": "PTA,CPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-11-06",
        "last_updated": "2023-11-06",
        "certification_date": "2023-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MN",
            "license": "A2871",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WI",
            "license": "4061",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ADRIAN",
            "last_name": "KANGE",
            "middle_name": "ELINGE",
            "credential": "PTA,CPT",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Glendale, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2023; 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.