NPIMap

Organization Active NPI

Clear Lake Physical Therapy and Rehab Specialists LLC

  • Physical Therapy Clinic/Center
  • Prairie Farm, WI
National Provider Identifier
1083328785
Registry record updated Jan 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
CLEAR LAKE PHYSICAL THERAPY AND REHAB SPECIALISTS LLC
Practice address
224 River Ave S
Prairie Farm, WI 54762-9786
Phone
(715) 263-4103
NPI assigned
Jan 9, 2023
Last updated
Jan 9, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2023

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

Authorized official

Name
Emily J Monson, PTNPI 1225042013
Title
Owen
Phone
(715) 263-4103

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

224 River Ave S
Prairie Farm, WI 54762-9786

Mailing address

PO Box 147
Clear Lake, WI 54005-8905
Phone (715) 263-4103

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1673222400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673222400000",
    "number": "1083328785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 147",
            "city": "CLEAR LAKE",
            "state": "WI",
            "postal_code": "540058905",
            "telephone_number": "715-263-4103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "224 RIVER AVE S",
            "city": "PRAIRIE FARM",
            "state": "WI",
            "postal_code": "547629786",
            "telephone_number": "715-263-4103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEAR LAKE PHYSICAL THERAPY AND REHAB SPECIALISTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-09",
        "last_updated": "2023-01-09",
        "certification_date": "2023-01-09",
        "status": "A",
        "authorized_official_last_name": "MONSON",
        "authorized_official_first_name": "EMILY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWEN",
        "authorized_official_telephone_number": "715-263-4103",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prairie Farm, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2023; 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.