Individual provider Active NPI

Corey Block, PT, DPT, CSCS

  • Physical Therapist
  • Madison, WI
National Provider Identifier
1972954667
Registry record updated Jun 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
13506 - 24 Issued in WI
Practice address
621 Science Dr
Mail Stop 9150
Madison, WI 53711-1074
Phone
(608) 266-6071
Fax
(608) 890-8568
NPI assigned
Jun 24, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 24, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 13506 - 24 WI Primary
Physical Therapist 225100000X 5501017753 MI

Addresses

Primary practice location

621 Science Dr
Mail Stop 9150
Madison, WI 53711-1074

Mailing address

621 Science Dr
Mail Stop 9150
Madison, WI 53711-1074
Phone (608) 266-6071

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
5501017753MIMDPhysical Therapist
13506 - 24WIMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1466726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466726400000",
    "number": "1972954667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 SCIENCE DR",
            "address_2": "MAIL STOP 9150",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537111074",
            "telephone_number": "608-266-6071",
            "fax_number": "608-890-8568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 SCIENCE DR",
            "address_2": "MAIL STOP 9150",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537111074",
            "telephone_number": "608-266-6071",
            "fax_number": "608-890-8568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOCK",
        "first_name": "COREY",
        "credential": "PT, DPT, CSCS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-24",
        "last_updated": "2016-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "13506 - 24",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501017753",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2016; 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.