Individual provider Active NPI

Joseph Blando

  • Physical Therapy Clinic/Center
  • Kenosha, WI
National Provider Identifier
1053297937
Registry record updated Aug 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
17476-24 Issued in WI
Practice address
7610 Pershing Blvd
Kenosha, WI 53142-4318
Phone
(262) 948-3600
NPI assigned
Aug 14, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X 17476-24 WI Primary

Addresses

Primary practice location

7610 Pershing Blvd
Kenosha, WI 53142-4318

Mailing address

7610 Pershing Blvd
Kenosha, WI 53142-4318
Phone (262) 948-3600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
17476-24WIMDPhysical Therapy Clinic/Center

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Health Care Southern Lakes, Inc. PastSince Aug 17, 2025 Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1755129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755129600000",
    "number": "1053297937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7610 PERSHING BLVD",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531424318",
            "telephone_number": "262-948-3600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7610 PERSHING BLVD",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531424318",
            "telephone_number": "262-948-3600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLANDO",
        "first_name": "JOSEPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-08-14",
        "last_updated": "2025-08-14",
        "certification_date": "2025-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "WI",
            "license": "17476-24",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Aug 14, 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.