Active NPI
Colleen De Wolf, PTA
- Physical Therapy Assistant
- Merrillville, IN
National Provider Identifier
1992661623
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 06001466A
- Practice address
- 9001 Broadway
Merrillville, IN 46410-7041 - Phone
- (219) 776-4023
- NPI assigned
- Dec 26, 2025
- 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 |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 06001466A | IN | |
| Physical Therapy Assistant | 225200000X | 06001466A | IN | Primary |
Addresses
Primary practice location
9001 Broadway
Merrillville, IN 46410-7041
Mailing address
9001 Broadway
Merrillville, IN 46410-7041
Phone (219) 776-4023
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 06001466A | Other | IN | LICENSE |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 06001466A | IN | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1766707200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1784851200000",
"number": "1992661623",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9001 BROADWAY",
"city": "MERRILLVILLE",
"state": "IN",
"postal_code": "464107041",
"telephone_number": "219-776-4023"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9001 BROADWAY",
"city": "MERRILLVILLE",
"state": "IN",
"postal_code": "464107041",
"telephone_number": "219-776-4023"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DE WOLF",
"first_name": "COLLEEN",
"credential": "PTA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-12-26",
"last_updated": "2026-07-24",
"certification_date": "2026-07-24",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "IN",
"license": "06001466A",
"primary": false
},
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "IN",
"license": "06001466A",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "06001466A",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Merrillville, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.