NPIMap

Organization Active NPI

Kenosha Achievement Center

  • Pediatric Physical Therapist
  • Kenosha, WI
National Provider Identifier
1013974849
Registry record updated Jan 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Physical TherapistTaxonomy code 2251P0200X
Legal business name
KENOSHA ACHIEVEMENT CENTER
Practice address
1218 79TH St
Kenosha, WI 53143-6111
Phone
(262) 658-9500
Fax
(262) 658-9621
NPI assigned
Apr 26, 2006
Last updated
Jan 8, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2026

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

Authorized official

Name
Mrs. Christine Weyker
Title
Ceo
Phone
(262) 658-9500

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Clinic/Center 261QR0400X
Pediatric Physical Therapist 2251P0200X Primary
Pediatric Occupational Therapist 225XP0200X
Speech-Language Pathologist 235Z00000X

Addresses

Primary practice location

1218 79TH St
Kenosha, WI 53143-6111

Mailing address

1218 79TH St
Kenosha, WI 53143-6111
Phone (262) 658-9500

Other identifiers 1

IdentifierTypeStateIssuer
41217500MedicaidWI

National Provider Directory

National Provider Directory

Locations

1218 79th St
Kenosha, WI 53143
Phone (262) 658-9500

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1767830400000",
    "number": "1013974849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1218 79TH ST",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531436111",
            "telephone_number": "262-658-9500",
            "fax_number": "262-764-0751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1218 79TH ST",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531436111",
            "telephone_number": "262-658-9500",
            "fax_number": "262-658-9621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENOSHA ACHIEVEMENT CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-26",
        "last_updated": "2026-01-08",
        "certification_date": "2026-01-08",
        "status": "A",
        "authorized_official_last_name": "WEYKER",
        "authorized_official_first_name": "CHRISTINE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "262-658-9500",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41217500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kenosha, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2026; 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.