Active NPI
Ryan R Westerberg, PT
- Orthopedic Physical Therapist
- Rockford, IL
National Provider Identifier
1124028287
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopedic Physical Therapist
- License
- 070010365
- Practice address
- 324 Roxbury Rd
Rockford, IL 61107-5090 - Phone
- (815) 398-9491
- Fax
- (815) 381-7498
- NPI assigned
- Jul 29, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopedic Physical Therapist | 2251X0800X | 070010365 | IL | Primary |
Addresses
Primary practice location
324 Roxbury Rd
Rockford, IL 61107-5090
Mailing address
Box 78534
Milwaukee, IL 53278
Phone (815) 398-9491
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050823000319 | IL | Practitioner - Physical Therapist in Private Practice | 2567493273 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 070010365 | IL | MD | Orthopedic Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Orthomidwest, PLLC | Orthopedic | Current | Accepting new patients |
| Orthomidwest, PLLC | Current | Accepting new patients | |
| Rockford Spine Center, LTD | Past | Accepting new patients |
Locations
770 Beloit Rd
Belvidere, IL 61008
Phone (815) 847-7060
2300 N Rockton Ave
Rockford, IL 61103
Phone (815) 971-5510
5875 E Riverside Blvd
Rockford, IL 61114
Phone (779) 774-1270
324 Roxbury Rd
Rockford, IL 61107
Phone (815) 381-7339
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Durable Medical Equipment & Medical Supplies
- Buffalo Grove, IL
- NPI 1043180839
-
- Orthopaedic Surgery of the Spine Physician
- Rockford, IL
- NPI 1124039391
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1122595200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1427155200000",
"number": "1124028287",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "BOX 78534",
"city": "MILWAUKEE",
"state": "IL",
"postal_code": "53278",
"telephone_number": "815-398-9491",
"fax_number": "815-381-7498"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "324 ROXBURY RD",
"city": "ROCKFORD",
"state": "IL",
"postal_code": "611075090",
"telephone_number": "815-398-9491",
"fax_number": "815-381-7498"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WESTERBERG",
"first_name": "RYAN",
"middle_name": "R",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-07-29",
"last_updated": "2015-03-24",
"status": "A"
},
"taxonomies": [
{
"code": "2251X0800X",
"taxonomy_group": "",
"desc": "Physical Therapist, Orthopedic",
"state": "IL",
"license": "070010365",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Rockford, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2015; 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.