Individual provider Active NPI

Ann Mattson, PTA

  • Physical Therapy Assistant
  • Monroe, WI
National Provider Identifier
1881859122
Registry record updated Jul 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
160004898 Issued in IL
Practice address
515 22ND Ave
Monroe, WI 53566-1569
Phone
(608) 324-2770
NPI assigned
Jul 25, 2008
Last updated
Jul 25, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2008

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 160004898 IL Primary

Addresses

Primary practice location

515 22ND Ave
Monroe, WI 53566-1569

Mailing address

9935 W Sabin Church Rd
Pearl City, IL 61062-9035

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
160004898ILMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1216944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216944000000",
    "number": "1881859122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9935 W SABIN CHURCH RD",
            "city": "PEARL CITY",
            "state": "IL",
            "postal_code": "610629035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 22ND AVE",
            "city": "MONROE",
            "state": "WI",
            "postal_code": "535661569",
            "telephone_number": "608-324-2770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTSON",
        "first_name": "ANN",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-25",
        "last_updated": "2008-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IL",
            "license": "160004898",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2008; 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.