NPIMap

Organization Active NPI

West Bend Clinic, Inc.

Doing business as Froedtert Health Rehabilitation and Sports Medicine Center

  • Occupational Therapist
  • Jackson, WI
National Provider Identifier
1124328232
Registry record updated Oct 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Legal business name
WEST BEND CLINIC, INC.
Doing business as
Froedtert Health Rehabilitation and Sports Medicine Center
Practice address
W227 N16857 Tillie Lake Court
Jackson, WI 53037-9000
Phone
(262) 365-6170
NPI assigned
Oct 25, 2010
Last updated
Oct 25, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2010

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

Authorized official

Name
James Browne
Title
Administrator
Phone
(262) 306-6536

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225100000X
Occupational TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225X00000X Primary

Addresses

Primary practice location

W227 N16857 Tillie Lake Court
Jackson, WI 53037-9000

Mailing address

1700 W Paradise Dr
West Bend, WI 53095
Phone (262) 334-3451

Other names 1

  • Froedtert Health Rehabilitation and Sports Medicine Center Doing business as

National Provider Directory

National Provider Directory

Locations

402 W Sumner St
Hartford, WI 53027
Phone (262) 670-4824

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1287964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1287964800000",
    "number": "1124328232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 W PARADISE DR",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "53095",
            "telephone_number": "262-334-3451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W227 N16857 TILLIE LAKE COURT",
            "city": "JACKSON",
            "state": "WI",
            "postal_code": "530379000",
            "telephone_number": "262-365-6170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST BEND CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-25",
        "last_updated": "2010-10-25",
        "status": "A",
        "authorized_official_last_name": "BROWNE",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "262-306-6536"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Froedtert Health Rehabilitation and Sports Medicine Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jackson, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2010; 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.