Individual provider Active NPI

Alyssa Suzanne Jones, DPT

  • Physical Therapist
  • Germantown, WI
National Provider Identifier
1811399934
Registry record updated Mar 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
12709 Issued in WI
Practice address
N112W17975 Mequon Rd
Germantown, WI 53022-2425
Phone
(262) 532-7600
Fax
(262) 532-7602
NPI assigned
Sep 19, 2014
Last updated
Mar 30, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2022

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 12709 WI Primary

Addresses

Primary practice location

N112W17975 Mequon Rd
Germantown, WI 53022-2425

Mailing address

3301 W Forest Home Ave
Milwaukee, WI 53215-2843
Phone (262) 532-7600

Other practice location 1

1100 Gateway Ct
West Bend, WI 53095-8539
Phone (262) 306-6100

Other identifiers 1

IdentifierTypeStateIssuer
100041115MedicaidWI

Other names 1

  • Alyssa S Tennies Former name

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address atennies104028@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
12709WIMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1411084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648598400000",
    "number": "1811399934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3301 W FOREST HOME AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532152843",
            "telephone_number": "262-532-7600",
            "fax_number": "262-532-7602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N112W17975 MEQUON RD",
            "city": "GERMANTOWN",
            "state": "WI",
            "postal_code": "530222425",
            "telephone_number": "262-532-7600",
            "fax_number": "262-532-7602"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1100 Gateway Ct",
            "address_purpose": "LOCATION",
            "city": "West Bend",
            "state": "WI",
            "postal_code": "530958539",
            "country_code": "US",
            "telephone_number": "262-306-6100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JONES",
        "first_name": "ALYSSA",
        "middle_name": "SUZANNE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-19",
        "last_updated": "2022-03-30",
        "certification_date": "2022-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "12709",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100041115",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "atennies104028@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1100 Gateway Ct",
            "city": "West Bend",
            "state": "WI",
            "country_code": "US",
            "postal_code": "530958539",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "1100 Gateway Ct",
            "city": "West Bend",
            "state": "WI",
            "country_code": "US",
            "postal_code": "530958539",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ALYSSA",
            "last_name": "TENNIES",
            "middle_name": "S",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Germantown, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2022; 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.