Evolve Physical Therapy and Sports Medicine LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

EVOLVE PHYSICAL THERAPY AND SPORTS MEDICINE LLC

Practice address

2691 N Lake Dr
Milwaukee, WI 53211-3838

Phone

(414) 840-9409

NPI assigned

Jan 10, 2023

Organization subpart

No

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

Authorized official

Name

Mr. Will Brucker, DPT

Title

Clinic Owner

Phone

(309) 287-2526

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Brittany R Bergman

  • Physical Therapist
  • Waukesha, WI
  • NPI 1548751662
  Medicare reassignment Care Compare group NPD
• Anne Hartay, DPT

  • Physical Therapist
  • Brookfield, WI
  • NPI 1134919459
  Medicare reassignment Care Compare group NPD
• Willis Brucker, DPT

  • Physical Therapist
  • Denver, CO
  • NPI 1255813622

  WI

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1673308800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673308800000",
    "number": "1043924319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2691 N LAKE DR",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532113838",
            "telephone_number": "414-840-9409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2691 N LAKE DR",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532113838",
            "telephone_number": "414-840-9409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVOLVE PHYSICAL THERAPY AND SPORTS MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-10",
        "last_updated": "2023-01-10",
        "certification_date": "2023-01-10",
        "status": "A",
        "authorized_official_last_name": "BRUCKER",
        "authorized_official_first_name": "WILL",
        "authorized_official_title_or_position": "CLINIC OWNER",
        "authorized_official_telephone_number": "309-287-2526",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Every Auer Transportation LLC
• Every Mother Counts LLC
• Everymove Transportation LLC
• Evoke Transportation LLC
• Evolutions Health Care LLC.
• Evolve Therapy Services LLC
• Griffin A Ewald, PT
• Kenneth Paul Ewert, BCBA
• Ewing Consulting LLC
• Michael James Ewing, MD

• Physical Therapy Clinic/Center in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Physical Therapy Clinic/Center in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.