Angela Lee Williquette, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

172-19 Issued in WI

Practice address

265 S National Ave
Fond Du Lac, WI 54935-5334

Phone

(920) 922-7342

NPI assigned

Jun 29, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

• Oasis Therapy Services LLC

  • Multi-Specialty Clinic/Center
  • Oshkosh, WI
  • NPI 1386381598
  NPD

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

{
    "created_epoch": "1624924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624924800000",
    "number": "1932779139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 14TH ST APT 7",
            "city": "FOND DU LAC",
            "state": "WI",
            "postal_code": "549355857",
            "telephone_number": "920-475-7852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "265 S NATIONAL AVE",
            "city": "FOND DU LAC",
            "state": "WI",
            "postal_code": "549355334",
            "telephone_number": "920-922-7342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIQUETTE",
        "first_name": "ANGELA",
        "middle_name": "LEE",
        "name_prefix": "Ms.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-29",
        "last_updated": "2021-06-29",
        "certification_date": "2021-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WI",
            "license": "172-19",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "-",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gail Williams
• Karen Ann Williams, APNP
• Sarah Jane Williams, NP
• Shaquiorya M Williams
• Tessa Williamson, L.AC
• David F. Wiltzius, LPC
• Carrie Windorff
• Kerry A Winget, SLP
• Wink Chiropractic Wellness Center, SC
• Craig S Wink, DC

• Physical Therapy Assistant in Fond Du Lac, WI
• Providers in Fond Du Lac, WI by specialty
• Physical Therapy Assistant in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2021; 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.