Premier Physical Medicine and Wellness Clinic

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

33657 Issued in WI

Legal business name

PREMIER PHYSICAL MEDICINE AND WELLNESS CLINIC

Practice address

1446 1St Ave
Woodruff, WI 54568-9149

Phone

(715) 356-9999

Fax

(715) 356-9894

NPI assigned

Oct 6, 2006

Organization subpart

No

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

Authorized official

Name

James E Mullen, M.D.

Title

Owner

Phone

(715) 356-9999

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 2

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

• Louis Voigt Smith Jr., DPT

  • Physical Therapist
  • Woodruff, WI
  • NPI 1205938123
  NPD (past)
• Jennifer A Vojta, ATC

  • Athletic Trainer
  • Woodruff, WI
  • NPI 1427187053
  NPD (past)

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1231372800000",
    "number": "1104913623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1550",
            "city": "WOODRUFF",
            "state": "WI",
            "postal_code": "545681550",
            "telephone_number": "715-356-9999",
            "fax_number": "715-356-9894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1446 1ST AVE",
            "city": "WOODRUFF",
            "state": "WI",
            "postal_code": "545689149",
            "telephone_number": "715-356-9999",
            "fax_number": "715-356-9894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER PHYSICAL MEDICINE AND WELLNESS CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-06",
        "last_updated": "2009-01-08",
        "status": "A",
        "authorized_official_last_name": "MULLEN",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "715-356-9999",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "WI",
            "license": "33657",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "21307000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Halley M Otto, PT
• Christopher Jay Pfaller, D.D.S.
• Barbara Lynn Phillips, DMD
• Molly Kathryn Pilarski, M.D.
• John J Pinzl
• Heidi Ann Pritzl, LCSW
• Redman & Gelinas SC
• Redman & Gelinas SC
• Benjamin K Redman, O.D.
• Jill C Redman, O.D.

• All providers in Woodruff, WI
• Physical Medicine & Rehabilitation Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2009; 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.