Active NPI
Delaney Josephine Bozec, PT DPT
- Physical Therapist
- Brookfield, WI
National Provider Identifier
1972199917
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 15310
- Practice address
- 17280 W North Ave
Brookfield, WI 53045-4366 - Phone
- (262) 780-0707
- NPI assigned
- Dec 14, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Physical Therapist | 2251P0200X | |||
| Physical Therapist | 225100000X | 15310 | WI | Primary |
Addresses
Primary practice location
17280 W North Ave
Brookfield, WI 53045-4366
Mailing address
1353 Swan Rd
De Pere, WI 54115-8209
Phone (920) 634-9936
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2000034400 | Other | WI | ATHLETIC TRAINING |
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 |
|---|---|---|---|
| 15310 | WI | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1607904000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1611792000000",
"number": "1972199917",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1353 SWAN RD",
"city": "DE PERE",
"state": "WI",
"postal_code": "541158209",
"telephone_number": "920-634-9936"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17280 W NORTH AVE",
"city": "BROOKFIELD",
"state": "WI",
"postal_code": "530454366",
"telephone_number": "262-780-0707"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOZEC",
"first_name": "DELANEY",
"middle_name": "JOSEPHINE",
"name_prefix": "Dr.",
"credential": "PT DPT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-12-14",
"last_updated": "2021-01-28",
"certification_date": "2021-01-27",
"status": "A"
},
"taxonomies": [
{
"code": "2251P0200X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Physical Therapist, Pediatrics",
"state": null,
"license": null,
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WI",
"license": "15310",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ATHLETIC TRAINING",
"identifier": "2000034400",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Brookfield, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 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.