Adam Altenburg

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

3012-19 Issued in WI

Practice address

104 Fakes CT
Beaver Dam, WI 53916-2699

Phone

(920) 356-9818

NPI assigned

Nov 5, 2020

Last updated

Nov 5, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1604534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604534400000",
    "number": "1205437340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 FAKES CT",
            "city": "BEAVER DAM",
            "state": "WI",
            "postal_code": "539162699",
            "telephone_number": "920-356-9818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 FAKES CT",
            "city": "BEAVER DAM",
            "state": "WI",
            "postal_code": "539162699",
            "telephone_number": "920-356-9818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALTENBURG",
        "first_name": "ADAM",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-11-05",
        "last_updated": "2020-11-05",
        "certification_date": "2020-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WI",
            "license": "3012-19",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "adam.altenburg@genesishcc.com",
            "affiliation": "N",
            "endpointDescription": "Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Email",
            "address_1": "104 Fakes Ct",
            "city": "Beaver Dam",
            "state": "WI",
            "country_code": "US",
            "postal_code": "539162699",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Area Oms

• Physical Therapy Assistant in Beaver Dam, WI
• Providers in Beaver Dam, WI by specialty
• Physical Therapy Assistant in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2020; 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.