NPIMap

Organization Active NPI

Daulton Physical Therapy, LLC

  • Physical Therapist
  • Hudson, WI
National Provider Identifier
1760806095
Registry record updated Jan 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
9757-24 Issued in WI
Legal business name
DAULTON PHYSICAL THERAPY, LLC
Practice address
726 Crosby Dr
Hudson, WI 54016-7869
Phone
(612) 961-4685
Fax
(715) 377-1737
NPI assigned
Feb 6, 2014
Last updated
Jan 13, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2015

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

Authorized official

Name
Jolene Daulton, PTNPI 1922296755
Title
Owner
Phone
(612) 961-4685

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 9757-24 WI Primary

Addresses

Primary practice location

726 Crosby Dr
Hudson, WI 54016-7869

Mailing address

726 Crosby Dr
Hudson, WI 54016-7869
Phone (612) 961-4685

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140908002760 WI Part B Supplier - Physical/Occupational Therapy Group in Private Practice 0345469284 Receives reassigned benefits from 5 practitioners
Practice locations: Hudson, WI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1391644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421107200000",
    "number": "1760806095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "726 CROSBY DR",
            "city": "HUDSON",
            "state": "WI",
            "postal_code": "540167869",
            "telephone_number": "612-961-4685",
            "fax_number": "715-377-1737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "726 CROSBY DR",
            "city": "HUDSON",
            "state": "WI",
            "postal_code": "540167869",
            "telephone_number": "612-961-4685",
            "fax_number": "715-377-1737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAULTON PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-06",
        "last_updated": "2015-01-13",
        "status": "A",
        "authorized_official_last_name": "DAULTON",
        "authorized_official_first_name": "JOLENE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "612-961-4685",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "9757-24",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hudson, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2015; 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.