Physical Achievement Center LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

4017-024

Legal business name

PHYSICAL ACHIEVEMENT CENTER LLC

Practice address

3475 Omro Rd Ste 300
Oshkosh, WI 54904

Phone

(920) 230-2747

Fax

(920) 385-7074

NPI assigned

Jul 13, 2017

Organization subpart

No

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

Authorized official

Name

Eric Leo Koehler, PT, DPT, OCSNPI 1700043502

Title

Owner

Phone

(920) 379-9692

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Locations

Practitioners 5

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

• Eric Koehler, PT

  • Physical Therapist
  • Oshkosh, WI
  • NPI 1700043502
  Medicare reassignment Care Compare group NPD Authorized official
• Alexander F Hart, PT, DPT, FAFS

  • Physical Therapist
  • Neenah, WI
  • NPI 1396912226
  Medicare reassignment Care Compare group NPD
• Lori J Schaetz, OTR, CLT

  • Occupational Therapist
  • Appleton, WI
  • NPI 1003951336
  Medicare reassignment Care Compare group NPD
• Jessica Nicole Strupp, PT, DPT

  • Physical Therapist
  • Oshkosh, WI
  • NPI 1336870872
  Medicare reassignment Care Compare group NPD
• Rebecca A Van Heuklon, PT

  • Physical Therapist
  • Ripon, WI
  • NPI 1053606376
  Medicare reassignment NPD

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

{
    "created_epoch": "1499904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1083136758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3475 OMRO RD STE 300",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549047126",
            "telephone_number": "920-230-2747",
            "fax_number": "920-385-7074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3475 OMRO RD STE 300",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "54904",
            "telephone_number": "920-230-2747",
            "fax_number": "920-385-7074"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3111 Sawyer Creek Dr",
            "address_purpose": "LOCATION",
            "city": "Oshkosh",
            "state": "WI",
            "postal_code": "549046362",
            "country_code": "US",
            "telephone_number": "920-379-9692",
            "fax_number": "920-385-7074",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PHYSICAL ACHIEVEMENT CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-13",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "KOEHLER",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "LEO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "920-379-9692",
        "authorized_official_credential": "PT, DPT, OCS"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": "4017-024",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40187000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Scott Michael Pethan, MS, BSN, RN
• Theresa Lynn Petrick Gatchell, OD
• Carol Jean Pfeilstifter, PTA LAT
• Kelly C. Phalin, PT
• Michael Philippi
• Elizabeth Ann Pickart, PT
• Phyllis Ann Pieplow, PDN RN RCS
• Karyn L Pierro, PT
• Kasey-Marie Pike
• Jenna Rose Pinnow, DPT

• Physical Therapist in Oshkosh, WI
• Providers in Oshkosh, WI by specialty
• Physical Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.