Alexander Jerrold Eggen, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

14606-24 Issued in WI

Practice address

113 4TH Ave
Shell Lake, WI 54871-4457

Phone

(715) 468-7833

NPI assigned

Jun 4, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Advantage Physical Therapy and Sports Rehab, LLCGroup PAC ID 8022016336, 289 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Advantage Physical Therapy & Sports Rehab, LLC

  • Rehabilitation Clinic/Center
  • Burlington, WI
  • NPI 1881773463

  WI

  Medicare reassignment Care Compare group NPD
• Advantage Physical Therapy & Sports Rehab, LLC

  • Rehabilitation Clinic/Center
  • Spooner, WI
  • NPI 1215687314
  Care Compare group NPD (past)
• Advantage Physical Therapy & Sports Rehab, LLC

  • Rehabilitation Clinic/Center
  • Cudahy, WI
  • NPI 1194396002
  Care Compare group
• Advantage Physical Therapy & Sports Rehab, LLC

  • Rehabilitation Clinic/Center
  • Hayward, WI
  • NPI 1902556012
  NPD
• Advantage Physical Therapy & Sports Rehab, LLC

  • Rehabilitation Clinic/Center
  • Salem, WI
  • NPI 1104497023
  NPD (past)

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

{
    "created_epoch": "1559606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559606400000",
    "number": "1003474065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 4TH AVE",
            "city": "SHELL LAKE",
            "state": "WI",
            "postal_code": "548714457",
            "telephone_number": "715-468-7833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 4TH AVE",
            "city": "SHELL LAKE",
            "state": "WI",
            "postal_code": "548714457",
            "telephone_number": "715-468-7833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EGGEN",
        "first_name": "ALEXANDER",
        "middle_name": "JERROLD",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-04",
        "last_updated": "2019-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "14606-24",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Juston Colvin, M.D.
• Bethany Curtis, COTA
• Dahlstroms Inc
• Edward Robert Dunbar, DDS
• Jeffrey Lemoine Dunham, MD
• Cathy Marie Ekern, LPC MA
• Eydie A Farrow, APNP
• Kenneth Joe Garrison, M.D.
• Merri Ann Gonzalez
• Amy Janine Grandadam, RN

• All providers in Shell Lake, WI
• Physical Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.