NPIMap

Organization Active NPI

In- Home Rehab Southeastern

  • Physical Therapist
  • Rochester, WI
National Provider Identifier
1215950696
Registry record updated Jun 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5627 Issued in WI
Legal business name
IN- HOME REHAB SOUTHEASTERN
Practice address
102 North State Street
Rochester, WI 53167
Phone
(262) 331-4397
NPI assigned
Jul 25, 2006
Last updated
Jun 17, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2008

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

Authorized official

Name
Eric William JohnsonNPI 1417971433
Title
Owner
Phone
(262) 331-4397

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X 5627 WI Primary
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X 4088026 WI

Addresses

Primary practice location

102 North State Street
Rochester, WI 53167

Mailing address

PO Box 367
Rochester, WI 53167-0367

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 9

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": "1153785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213660800000",
    "number": "1215950696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 367",
            "city": "ROCHESTER",
            "state": "WI",
            "postal_code": "531670367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 NORTH STATE STREET",
            "city": "ROCHESTER",
            "state": "WI",
            "postal_code": "53167",
            "telephone_number": "262-331-4397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IN- HOME REHAB SOUTHEASTERN",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-25",
        "last_updated": "2008-06-17",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "262-331-4397"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "5627",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "4088026",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2008; 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.