Individual provider Active NPI

Rebecca A Van Heuklon, PT

  • Physical Therapist
  • Ripon, WI
National Provider Identifier
1053606376
Registry record updated May 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
11752 Issued in WI
Practice address
1242 W Fond Du Lac St
Ripon, WI 54971-9288
Phone
(920) 745-4700
NPI assigned
Jun 15, 2011
Last updated
May 5, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 11752 WI Primary

Addresses

Primary practice location

1242 W Fond Du Lac St
Ripon, WI 54971-9288

Mailing address

PO Box 735044
Chicago, IL 60673-5044
Phone (800) 326-2250

Other practice location 1

1305 W American Dr
Neenah, WI 54956-1993
Phone (920) 729-7665

Other identifiers 1

IdentifierTypeStateIssuer
100015730MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address rvanheuklon411966@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110727000765 WI Practitioner - Physical Therapist in Private Practice 6709054265 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aurora Medical Group, Inc.Group PAC ID 6709794258, 3,764 clinicians

Practice addresses (Care Compare)

1020 N 12TH St
Milwaukee, WI 53233-1308
Phone (414) 219-3056

1242 W Fond Du Lac St
Ripon, WI 54971-9288
Phone (920) 745-4700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11752WIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeshore Medical Clinic, LLC Physical Therapist CurrentSince Dec 5, 2024 Accepting new patients
Physical Achievement Center LLC Physical Therapist CurrentSince Aug 2, 2021 Accepting new patients
Aurora Advanced Healthcare, Inc. CurrentSince Dec 5, 2024 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Dec 5, 2024 Accepting new patients
Aurora Medical Group, Inc. Current Accepting new patients
Aurora Advanced Healthcare Inc CurrentSince Dec 5, 2024 Accepting new patients
The Neuroscience Group of Northeast Wisconsin SC Physical Therapist CurrentSince May 9, 2014 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Dec 5, 2024 Accepting new patients
STCH de Pere Wi Opco LLC PastSince Jan 22, 2018 Accepting new patients

Locations

3003 W Good Hope Rd
Glendale, WI 53209
Phone (414) 352-3100

12203 N Corporate Pkwy
Mequon, WI 53092
Phone (262) 387-8200

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

S74W16775 Janesville Rd
Muskego, WI 53150
Phone (414) 422-4747

130 2nd St
Neenah, WI 54956
Phone (920) 729-2063

1305 West American Dr
Neenah, WI 54956
Phone (920) 729-7687

2080 W 9th Ave
Oshkosh, WI 54904

3475 Omro Rd
Ste 100
Oshkosh, WI 54904
Phone (920) 230-2747

1242 W Fond du Lac St
Ripon, WI 54971
Phone (920) 722-7747

2000 E Layton Ave
St Francis, WI 53235
Phone (414) 744-7880

Interoperability endpoints

  • Direct secure messaging: rvanheuklon411966@direct.myadvocateaurora.org

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1308096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746403200000",
    "number": "1053606376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735044",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606735044",
            "telephone_number": "800-326-2250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1242 W FOND DU LAC ST",
            "city": "RIPON",
            "state": "WI",
            "postal_code": "549719288",
            "telephone_number": "920-745-4700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1305 W American Dr",
            "address_purpose": "LOCATION",
            "city": "Neenah",
            "state": "WI",
            "postal_code": "549561993",
            "country_code": "US",
            "telephone_number": "920-729-7665",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAN HEUKLON",
        "first_name": "REBECCA",
        "middle_name": "A",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-15",
        "last_updated": "2025-05-05",
        "certification_date": "2025-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "11752",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100015730",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rvanheuklon411966@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1242 W Fond Du Lac St",
            "city": "Ripon",
            "state": "WI",
            "country_code": "US",
            "postal_code": "549719288",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "1242 W Fond Du Lac St",
            "city": "Ripon",
            "state": "WI",
            "country_code": "US",
            "postal_code": "549719288",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Ripon, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2025; 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.