Individual provider Active NPI

Ryan R Westerberg, PT

  • Orthopedic Physical Therapist
  • Rockford, IL
National Provider Identifier
1124028287
Registry record updated Mar 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
070010365 Issued in IL
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

Updated by the provider on Mar 24, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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 IDStateProvider typePAC IDDetails
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

LicenseStateTypeSpecialty
070010365ILMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Orthomidwest, PLLC Orthopedic CurrentSince Aug 3, 2009 Accepting new patients
Orthomidwest, PLLC CurrentSince Aug 3, 2009 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.

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.

Verify at the official NPI Registry.