Individual provider Active NPI

Bonnie J Sperberg, P.T.

  • Physical Therapist
  • Waupaca, WI
National Provider Identifier
1083982821
Registry record updated Dec 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2211-24 Issued in WI
Practice address
1226 Berlin St
Waupaca, WI 54981-1991
Phone
(715) 942-1422
NPI assigned
Dec 7, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2211-24 WI Primary

Addresses

Primary practice location

1226 Berlin St
Waupaca, WI 54981-1991

Mailing address

N4723 26TH LN
Pine River, WI 54965-8131
Phone (920) 622-5248

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2211-24WIMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1323216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323216000000",
    "number": "1083982821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N4723 26TH LN",
            "city": "PINE RIVER",
            "state": "WI",
            "postal_code": "549658131",
            "telephone_number": "920-622-5248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1226 BERLIN ST",
            "city": "WAUPACA",
            "state": "WI",
            "postal_code": "549811991",
            "telephone_number": "715-942-1422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPERBERG",
        "first_name": "BONNIE",
        "middle_name": "J",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-07",
        "last_updated": "2011-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "2211-24",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waupaca, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2011; 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.