MEDICARE: DEANNA SIMONSON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2251P0200X	Pediatric Physical Therapist	4669-024	WI

General Provider Information

NPI Number	:	1538266267
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEANNA SIMONSON

Provider Business Mailing Address
First Line	:	3042 YARMOUTH GREENWAY DR
Second Line	:
City	:	FITCHBURG
State	:	WI
Zip	:	53711-6922
Country	:	US
Telephone Number	:	608-516-8948
Fax Number	:

Provider Business Practice Location Address
First Line	:	6602 INNER DR
Second Line	:
City	:	MADISON
State	:	WI
Zip	:	53705-4219
Country	:	US
Telephone Number	:	608-663-8170
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/17/2006
Last Update Date	:	03/16/2026

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Directions to “ DEANNA SIMONSON ” Practice Location

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