Active NPI
Jennifer La Plante, PT
- Physical Therapist
- Wauwatosa, WI
National Provider Identifier
1912038662
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 10784024
- Practice address
- 6810 W State St
Wauwatosa, WI 53213-2807 - Phone
- (414) 259-0623
- Fax
- (414) 259-0746
- NPI assigned
- Mar 7, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 10784024 | WI | Primary |
Addresses
Primary practice location
6810 W State St
Wauwatosa, WI 53213-2807
Mailing address
790 Remington Blvd
Bolingbrook, IL 60440-4909
Phone (866) 370-8206
Other names 1
- Jennifer E Fedak
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
| License | State | Type | Specialty |
|---|---|---|---|
| 10784024 | WI | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Athletic & Therapeutic Institute of Milwaukee, LLC | Physical Therapist | Current | Accepting new patients |
Locations
790 Remington Blvd
Bolingbrook, IL 60440
S74W16867 Janesville Rd
Muskego, WI 53150
Phone (262) 971-4200
Interoperability endpoints
- jennifer.laplante.2@14940.direct.athenahealth.com
- jennifer.laplante.1@14940.direct.athenahealth.com
Organizations & group practices 1
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.
-
- Physical Therapist
- Pewaukee, WI
- NPI 1801907464
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173225600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1704240000000",
"number": "1912038662",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "790 REMINGTON BLVD",
"city": "BOLINGBROOK",
"state": "IL",
"postal_code": "604404909",
"telephone_number": "866-370-8206",
"fax_number": "517-435-3670"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6810 W STATE ST",
"city": "WAUWATOSA",
"state": "WI",
"postal_code": "532132807",
"telephone_number": "414-259-0623",
"fax_number": "414-259-0746"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LA PLANTE",
"first_name": "JENNIFER",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-07",
"last_updated": "2024-01-03",
"certification_date": "2024-01-03",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WI",
"license": "10784024",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JENNIFER",
"last_name": "FEDAK",
"middle_name": "E",
"credential": "PT",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Wauwatosa, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.