Individual provider Active NPI

Antoinette Joanne Klauck, PTA

  • Physical Therapy Assistant
  • Milwaukee, WI
National Provider Identifier
1821321001
Registry record updated Sep 7, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
1467-019 Issued in WI
Practice address
5663 S 27TH St
Milwaukee, WI 53221-4107
Phone
(414) 282-7810
NPI assigned
Sep 7, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 1467-019 WI Primary

Addresses

Primary practice location

5663 S 27TH St
Milwaukee, WI 53221-4107

Mailing address

5663 S 27TH St
Milwaukee, WI 53221-4107
Phone (414) 282-7810

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
1467-019WIMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1252281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1252281600000",
    "number": "1821321001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5663 S 27TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532214107",
            "telephone_number": "414-282-7810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5663 S 27TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532214107",
            "telephone_number": "414-282-7810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLAUCK",
        "first_name": "ANTOINETTE",
        "middle_name": "JOANNE",
        "name_prefix": "Mrs.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-07",
        "last_updated": "2009-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WI",
            "license": "1467-019",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Sep 7, 2009; 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.