Wisconsin Athletic Club, LLC

Primary specialty

Recovery Care Clinic/CenterTaxonomy code 261QR0800X

Legal business name

WISCONSIN ATHLETIC CLUB, LLC

Practice address

N91W15700 Falls Pkwy
Menomonee Falls, WI 53051-2301

Phone

(262) 255-5700

NPI assigned

Jun 19, 2025

Last updated

Jun 19, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Morgan King

Title

Physical Therapist

Phone

(262) 255-5700

Specialties & licenses 1

Addresses

Tax ID family

Wisconsin Athletic Club LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Wisconsin Athletic Club, LLC

  • Health Maintenance Organization
  • Glendale, WI
  • NPI 1356260129
  NPD tax ID
• Wisconsin Athletic Club, LLC

  • Physical Therapist
  • Milwaukee, WI
  • NPI 1609756204
  NPD tax ID

Locations

Practitioners 1

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.

• Carla Ebert Larson, ATC, PAS, CSCS

  • Athletic Trainer
  • Menomonee Falls, WI
  • NPI 1518935212
  NPD (past)

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

{
    "created_epoch": "1750291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750291200000",
    "number": "1043107428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10840 W ROGERS ST",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532271135",
            "telephone_number": "414-328-1300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N91W15700 FALLS PKWY",
            "city": "MENOMONEE FALLS",
            "state": "WI",
            "postal_code": "530512301",
            "telephone_number": "262-255-5700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "411 E Wisconsin Ave Fl 6",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532024461",
            "country_code": "US",
            "telephone_number": "414-212-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "WISCONSIN ATHLETIC CLUB, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-19",
        "last_updated": "2025-06-19",
        "certification_date": "2025-05-30",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "MORGAN",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "262-255-5700"
    },
    "taxonomies": [
        {
            "code": "261QR0800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Recovery Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicholas Williams, MD
• Samantha J Williams, OTR/L
• Mary Kay Winarski, NP
• Amber Winquist-Bailey, DPT
• Salina Winslow, PTA
• Wisconsin CVS Pharmacy LLC (CVS Pharmacy #04996)
• Wisconsin CVS Pharmacy LLC (CVS Pharmacy #16301)
• Wisconsin Dental Group, S.C. (ForwardDental Menomonee Falls)
• Wisconsin Vision, LLC
• Laura A Wittlin, MS, RD CD

• Recovery Care Clinic/Center in Menomonee Falls, WI
• Providers in Menomonee Falls, WI by specialty
• Recovery Care Clinic/Center in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2025; 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.