Individual provider Active NPI

Jennifer Jean Perdue, P.T.

  • Physical Therapist
  • Milwaukee, WI
National Provider Identifier
1861683716
Registry record updated Aug 6, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
6523-024 Issued in WI
Practice address
2060 N Humboldt Ave
Milwaukee, WI 53212-3504
Phone
(414) 265-5606
Fax
(414) 265-5649
NPI assigned
Aug 6, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 6523-024 WI Primary
Physical Therapist 225100000X 5501010427 MI

Addresses

Primary practice location

2060 N Humboldt Ave
Milwaukee, WI 53212-3504

Mailing address

2060 N Humboldt Ave
Milwaukee, WI 53212-3504

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
6523WIMDInternal Medicine Physician
5501010427MIMDPhysical Therapist
6523-024WIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince Mar 23, 2019 Accepting new patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince Mar 23, 2019 Accepting new patients

Locations

W168N11237 Western Ave
Germantown, WI 53022
Phone (262) 253-5060

7901 S 6th St
Oak Creek, WI 53154
Phone (414) 346-8000

1155 N Mayfair Rd
Wauwatosa, WI 53226
Phone (414) 955-5990

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": "1186358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1186358400000",
    "number": "1861683716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2060 N HUMBOLDT AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532123504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2060 N HUMBOLDT AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532123504",
            "telephone_number": "414-265-5606",
            "fax_number": "414-265-5649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERDUE",
        "first_name": "JENNIFER",
        "middle_name": "JEAN",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-06",
        "last_updated": "2007-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "6523-024",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501010427",
            "primary": false
        }
    ],
    "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 Aug 6, 2007; 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.