Organization Active NPI

The Wellness Clinic Inc.

  • Physical Therapist
  • Marinette, WI
National Provider Identifier
1124456330
Registry record updated Apr 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
THE WELLNESS CLINIC INC.
Practice address
1281 Marinette Ave
Marinette, WI 54143-2018
Phone
(715) 735-5500
Fax
(715) 735-5502
NPI assigned
Oct 24, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2014

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

Authorized official

Name
Mr. Jason Koenigs, PT
Title
President and Cfo
Phone
(715) 735-5500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

1281 Marinette Ave
Marinette, WI 54143-2018

Mailing address

1281 Marinette Ave
Marinette, WI 54143-2018
Phone (715) 735-5500

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1382572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1397174400000",
    "number": "1124456330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1281 MARINETTE AVE",
            "city": "MARINETTE",
            "state": "WI",
            "postal_code": "541432018",
            "telephone_number": "715-735-5500",
            "fax_number": "715-735-5502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1281 MARINETTE AVE",
            "city": "MARINETTE",
            "state": "WI",
            "postal_code": "541432018",
            "telephone_number": "715-735-5500",
            "fax_number": "715-735-5502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE WELLNESS CLINIC INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-24",
        "last_updated": "2014-04-11",
        "status": "A",
        "authorized_official_last_name": "KOENIGS",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "PRESIDENT AND CFO",
        "authorized_official_telephone_number": "715-735-5500",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marinette, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2014; 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.