Paul E Niemuth, PT,DSC,OCS,SCS,ATC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1811-024 Issued in WI

Practice address

112 Ash St
Suite 5
Spooner, WI 54801-1487

Phone

(715) 635-2518

Fax

(866) 245-8064

NPI assigned

Mar 3, 2006

Last updated

Aug 1, 2017By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Spooner Physical Therapy & Wellness Inc

  • Physical Therapist
  • Spooner, WI
  • NPI 1093226011
  NPD (past)

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

{
    "created_epoch": "1141344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1501545600000",
    "number": "1083681407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 52ND ST STE 240",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531403423",
            "telephone_number": "262-925-5000",
            "fax_number": "262-925-5001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 ASH ST",
            "address_2": "SUITE 5",
            "city": "SPOONER",
            "state": "WI",
            "postal_code": "548011487",
            "telephone_number": "715-635-2518",
            "fax_number": "866-245-8064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIEMUTH",
        "first_name": "PAUL",
        "middle_name": "E",
        "credential": "PT,DSC,OCS,SCS,ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-03",
        "last_updated": "2017-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "1739",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "1811-024",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11363195",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1083681407",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Natalie Dawn Neinstadt, CRNA, APNP, APRN, MS
• Charles E Nelson, MD
• Diane K Noe, PT
• Northwest Passage - Northwest Passage II
• Kathleen Ann Olsen
• Parkinson Dermatology SC
• Katherine E Parkinson, M.D.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2017; 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.