Individual provider Active NPI

Dennis Chester Sobush, PT, MA, DPT, CCS

  • Cardiopulmonary Physical Therapist
  • Greenfield, WI
National Provider Identifier
1003943572
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiopulmonary Physical TherapistTaxonomy code 2251C2600X
License
1436-024 Issued in WI
Practice address
3920 S 120TH St
Greenfield, WI 53228-1882
Phone
(414) 546-2667
NPI assigned
Feb 28, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiopulmonary Physical Therapist 2251C2600X 1436-024 WI Primary

Addresses

Primary practice location

3920 S 120TH St
Greenfield, WI 53228-1882

Mailing address

3920 S 120TH St
Greenfield, WI 53228-1882
Phone (414) 546-2667

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)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
1436-024WIMDCardiopulmonary Physical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1003943572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3920 S 120TH ST",
            "city": "GREENFIELD",
            "state": "WI",
            "postal_code": "532281882",
            "telephone_number": "414-546-2667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3920 S 120TH ST",
            "city": "GREENFIELD",
            "state": "WI",
            "postal_code": "532281882",
            "telephone_number": "414-546-2667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOBUSH",
        "first_name": "DENNIS",
        "middle_name": "CHESTER",
        "name_prefix": "Dr.",
        "credential": "PT, MA, DPT, CCS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251C2600X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Cardiopulmonary",
            "state": "WI",
            "license": "1436-024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenfield, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.