Individual provider Active NPI

Kerry Ammann, PT

  • Physical Therapist
  • Milwaukee, WI
National Provider Identifier
1811020779
Registry record updated Aug 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
4252-24 Issued in WI
Practice address
8901 N 76TH St
Milwaukee, WI 53223-1901
Phone
(414) 354-0772
Fax
(414) 365-0773
NPI assigned
Mar 13, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 18, 2015

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 4252-24 WI Primary

Addresses

Primary practice location

8901 N 76TH St
Milwaukee, WI 53223-1901

Mailing address

2205 N Summit Ave
Milwaukee, WI 53202-1213
Phone (414) 839-7861

Other identifiers 1

IdentifierTypeStateIssuer
40368100MedicaidWI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120725000831 WI Practitioner - Physical Therapist in Private Practice 5890951446 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4252-24WIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Pain Management & Treatment Center, S.C. CurrentSince Jun 1, 2012 Accepting new patients
NSH Sunrise LLC Past Accepting new patients

Locations

6400 Industrial Loop
Greendale, WI 53129
Phone (414) 423-4100

8901 N 76th St
Milwaukee, WI 53223
Phone (414) 354-0772

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439856000000",
    "number": "1811020779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2205 N SUMMIT AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532021213",
            "telephone_number": "414-839-7861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8901 N 76TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532231901",
            "telephone_number": "414-354-0772",
            "fax_number": "414-365-0773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMMANN",
        "first_name": "KERRY",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-13",
        "last_updated": "2015-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "4252-24",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40368100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 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.