Sandra Rae Fondow, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

10475 Issued in WI

Practice address

1630 Commanche Ave
Green Bay, WI 54313-5753

Phone

(920) 430-4750

NPI assigned

Dec 7, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sfondow32297@direct.thedacare.org

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.

• Bellin Memorial Hospital Inc

  dba Bellin Health Algoma

  • Rural Health Clinic/Center
  • Algoma, WI
  • NPI 1609838473
  Medicare reassignment NPD
• Bellin Memorial Hospital Inc

  dba Bellin Health

  • Family Medicine Physician
  • Green Bay, WI
  • NPI 1033172390

  Physical Therapist

  NPD
• Bellin Memorial Hospital Inc

  dba FMC DePere West

  • Family Medicine Physician
  • De Pere, WI
  • NPI 1053374314
  NPD
• Bellin Memorial Hospital Inc

  dba FMC Brillion

  • Family Medicine Physician
  • Brillion, WI
  • NPI 1962464784
  NPD (past)

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

{
    "created_epoch": "1133913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564617600000",
    "number": "1083699664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22487",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543052487",
            "telephone_number": "920-445-7222",
            "fax_number": "920-445-7289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1630 COMMANCHE AVE",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543135753",
            "telephone_number": "920-430-4750"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1800 Lawrence Dr",
            "address_purpose": "LOCATION",
            "city": "DE Pere",
            "state": "WI",
            "postal_code": "541159108",
            "country_code": "US",
            "telephone_number": "920-983-3220",
            "fax_number": "920-983-3226",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "725 S Webster Ave",
            "address_purpose": "LOCATION",
            "city": "Green Bay",
            "state": "WI",
            "postal_code": "543013500",
            "country_code": "US",
            "telephone_number": "920-433-3655",
            "fax_number": "920-433-3539",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "744 S Webster Ave",
            "address_purpose": "LOCATION",
            "city": "Green Bay",
            "state": "WI",
            "postal_code": "543013505",
            "country_code": "US",
            "telephone_number": "920-433-7822",
            "fax_number": "920-433-3651",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1580 Commanche Ave",
            "address_purpose": "LOCATION",
            "city": "Green Bay",
            "state": "WI",
            "postal_code": "543135751",
            "country_code": "US",
            "telephone_number": "920-435-8326",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3263 Eaton Rd",
            "address_purpose": "LOCATION",
            "city": "Green Bay",
            "state": "WI",
            "postal_code": "543116830",
            "country_code": "US",
            "telephone_number": "920-433-6700",
            "fax_number": "920-043-3671",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FONDOW",
        "first_name": "SANDRA",
        "middle_name": "RAE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-07",
        "last_updated": "2019-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "10475",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "10475-024",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tracy Fochs, BCBA
• Kay Ann Fogeltanz, DC
• Joanne Folcik
• Brian Foley
• Erica Widas Folker
• Cindy L Fonseca-Shivers, LPC, LCSW
• Alia Victoria Linelle Fonseca, MD
• Caitlyn Forbes, PA-C
• Sally Lynn Forcey, PTA
• Sarah Sue Ford, PT, DPT

• Physical Therapist in Green Bay, WI
• Providers in Green Bay, 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, 2019; 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.