Individual provider Active NPI

Kristi L Horneck, PT, DPT

  • Physical Therapist
  • Manitowoc, WI
National Provider Identifier
1063626158
Registry record updated Oct 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40389600 Issued in WI
Practice address
1212 Memorial Dr # 1
Manitowoc, WI 54220-2247
Phone
(920) 652-9554
Fax
(920) 652-9556
NPI assigned
May 9, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 4719-24 WI
Physical Therapist 225100000X 40389600 WI Primary

Addresses

Primary practice location

1212 Memorial Dr # 1
Manitowoc, WI 54220-2247

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909
Phone (866) 370-8206

Other practice location 1

3100 Superior Ave
Sheboygan, WI 53081-1948
Phone (920) 459-8300

Other practice location 2

825 Walton Dr
Plymouth, WI 53073-5022
Phone (920) 496-4700

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address khorneck341670@ewd.direct.hshs.org Direct

Medicare participation

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

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
83.05 of 100Reported as group
Quality
88.38
Improvement activities
40
Cost
64.82

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4719WIMDGeneral Practice Dentistry
4719-24WIMDPhysical Medicine & Rehabilitation Physician
40389600WIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Athletic & Therapeutic Institute of Milwaukee, LLC Physical Therapist CurrentSince Nov 13, 2023 Accepting new patients
Athletic & Therapeutic Institute of Milwaukee, LLC Physical Therapist CurrentSince Nov 13, 2023 Accepting new patients
Athletic & Therapeutic Institute of Milwaukee, LLC Physical Therapist PastSince Nov 5, 2023 Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

1212 Memorial Dr
#120
Manitowoc, WI 54220
Phone (920) 652-9554

1212 Memorial Dr
#1
Manitowoc, WI 54220
Phone (920) 652-9554

S74W16867 Janesville Rd
Muskego, WI 53150
Phone (262) 971-4200

Interoperability endpoints

  • Direct secure messaging: kristi.horneck.1@14940.direct.athenahealth.com
  • Direct secure messaging: khorneck341670@ewd.direct.hshs.org

Organizations & group practices 3

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": "1178668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698710400000",
    "number": "1063626158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909",
            "telephone_number": "866-370-8206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1212 MEMORIAL DR # 1",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542202247",
            "telephone_number": "920-652-9554",
            "fax_number": "920-652-9556"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3100 Superior Ave",
            "address_purpose": "LOCATION",
            "city": "Sheboygan",
            "state": "WI",
            "postal_code": "530811948",
            "country_code": "US",
            "telephone_number": "920-459-8300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "825 Walton Dr",
            "address_purpose": "LOCATION",
            "city": "Plymouth",
            "state": "WI",
            "postal_code": "530735022",
            "country_code": "US",
            "telephone_number": "920-496-4700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HORNECK",
        "first_name": "KRISTI",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-09",
        "last_updated": "2023-10-31",
        "certification_date": "2023-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "WI",
            "license": "4719-24",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "40389600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "khorneck341670@ewd.direct.hshs.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "825 Walton Dr",
            "city": "Plymouth",
            "state": "WI",
            "country_code": "US",
            "postal_code": "530735022",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Manitowoc, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.