Sierra Renee Kaczocha

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

CP053720T Issued in WI

Practice address

1405 Mill St
New London, WI 54961-2155

Phone

(920) 531-2031

Fax

(920) 531-2056

NPI assigned

Jun 17, 2024

Last updated

Mar 11, 2026By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Colorado Athletic Conditioning Clinic Lowry Professional LLCGroup PAC ID 0648293605, 44 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Colorado Athletic Conditioning Clinic Lowry Professional LLC

  • Specialist
  • Denver, CO
  • NPI 1720162084
  Medicare reassignment Care Compare group NPD
• Colorado Athletic Conditioning Clinic Lowry Professional LLC

  • Physical Therapist
  • Colorado Springs, CO
  • NPI 1720973597
  NPD
• Colorado Athletic Conditioning Clinic Lowry Professional LLC

  • Physical Therapist
  • Colorado Springs, CO
  • NPI 1992559546
  NPD

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

{
    "created_epoch": "1718582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773187200000",
    "number": "1033952197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 E BROADWAY RD STE 101",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852821535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1405 MILL ST",
            "city": "NEW LONDON",
            "state": "WI",
            "postal_code": "549612155",
            "telephone_number": "920-531-2031",
            "fax_number": "920-531-2056"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1025 E Broadway Rd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Tempe",
            "state": "AZ",
            "postal_code": "852821535",
            "country_code": "US",
            "telephone_number": "623-692-8210",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KACZOCHA",
        "first_name": "SIERRA",
        "middle_name": "RENEE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-06-17",
        "last_updated": "2026-03-11",
        "certification_date": "2026-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "PTL.0020243",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "CP050081T",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "CP053720T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Lee Jernegan, RPH
• Karly Lynn Johannsen
• Todd Robert Johnson, NP
• Amy Jordan
• Julie Feider, Mse, LPC
• Ross Hayland Kading, D.C.
• Teasha L Kaepernick, PA
• Margit Kindel, PTA
• Nathan King
• Rebecca Kathryn Kisley, MS, LPC, SAC

• Physical Therapist in New London, WI
• Providers in New London, WI by specialty
• Physical Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2026; 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.