Taylor Wickman

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

15942-24 Issued in WI

Practice address

2700 W Honadel Blvd
Oak Creek, WI 53154-2650

Phone

(414) 435-2005

NPI assigned

Dec 13, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Mercy Health System Corporation

  • Multi-Specialty Clinic/Center
  • Janesville, WI
  • NPI 1598718603
  Medicare reassignment NPD
• Mercy Health System Corporation

  • General Acute Care Hospital
  • Janesville, WI
  • NPI 1093768962
  NPD
• Mercy Health System Corporation

  • Critical Access Hospital
  • Lake Geneva, WI
  • NPI 1699728550
  NPD

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

{
    "created_epoch": "1670889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670889600000",
    "number": "1922719632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2543 W APPLEBROOK LN APT 209",
            "city": "OAK CREEK",
            "state": "WI",
            "postal_code": "531548820",
            "telephone_number": "906-221-7897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 W HONADEL BLVD",
            "city": "OAK CREEK",
            "state": "WI",
            "postal_code": "531542650",
            "telephone_number": "414-435-2005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WICKMAN",
        "first_name": "TAYLOR",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-12-13",
        "last_updated": "2022-12-13",
        "certification_date": "2022-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "15942-24",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William W Weis, DPM
• Melissa Ann Weise, APNP
• Lauren Wesolowski, OT
• Catalina West-Equivel
• Danesha Renee White
• Jeffrey Wieczorek, O.T.
• Lowell Wietlispach
• Kori J. Wiken
• Ashley Wilbrandt
• Nicole Wilke

• Physical Therapist in Oak Creek, WI
• Providers in Oak Creek, WI by specialty
• Physical Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.