Peter Stathas

Primary specialty

Physical TherapistTaxonomy code 225100000X

Practice address

6908 N Santa Monica Blvd
Fox Point, WI 53217-3942

Phone

(414) 352-2082

Fax

(414) 352-5279

NPI assigned

Jul 25, 2006

Last updated

Apr 13, 2010By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

• Freedom Physical Therapy Services SC

  • Physical Therapist
  • Fox Point, WI
  • NPI 1063406544
  Authorized official Same address or phone

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1271116800000",
    "number": "1013930650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6908 N SANTA MONICA BLVD",
            "city": "FOX POINT",
            "state": "WI",
            "postal_code": "532173942",
            "telephone_number": "414-352-2082",
            "fax_number": "414-352-5279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6908 N SANTA MONICA BLVD",
            "city": "FOX POINT",
            "state": "WI",
            "postal_code": "532173942",
            "telephone_number": "414-352-2082",
            "fax_number": "414-352-5279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STATHAS",
        "first_name": "PETER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2010-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40185600",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Norman Schwartz, MD
• Jennifer A Scott, MSW, LCSW
• SE Professionals SC (Premier Vision)
• Syed Yawar Shafi, PHARMD
• Stephanie Smith, DPT
• Heather Elizabeth Stern, OD
• Jamie Lynn Trettin, LPC
• VA Transportation
• Valerie Laabs-Siemon LLC
• Marion Verplancke

• Physical Therapist in Fox Point, WI
• Providers in Fox Point, WI by specialty
• Physical Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2010; 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.