Advance Therapy Center Inc

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

3756-024 Issued in WI

Legal business name

ADVANCE THERAPY CENTER INC

Practice address

3475 Omro Rd
Ste. 300
Oshkosh, WI 54904-7125

Phone

(920) 233-7177

NPI assigned

Apr 24, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Karla J King

Title

Office Manager

Phone

(920) 233-7177

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1003035767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3475 OMRO RD",
            "address_2": "STE. 300",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549047125",
            "telephone_number": "920-233-7177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3475 OMRO RD",
            "address_2": "STE. 300",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549047125",
            "telephone_number": "920-233-7177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCE THERAPY CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "KARLA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "920-233-7177"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "3756-024",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41219900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.