NPIMap

Organization Active NPI

Cedarburg Physical Therapy, Inc

  • Physical Therapy Clinic/Center
  • Cedarburg, WI
National Provider Identifier
1225040926
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
CEDARBURG PHYSICAL THERAPY, INC
Practice address
W63N541 Hanover Ave
Cedarburg, WI 53012-1917
Phone
(262) 375-2195
Fax
(262) 375-2273
NPI assigned
Aug 12, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Brandon G Goldbeck, D.P.T.NPI 1578563979
Title
President
Phone
(262) 375-2195

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X NU Primary

Addresses

Primary practice location

W63N541 Hanover Ave
Cedarburg, WI 53012-1917

Mailing address

W63N541 Hanover Ave
Cedarburg, WI 53012-1917
Phone (262) 375-2195

Other identifiers 1

IdentifierTypeStateIssuer
86687MedicaidWI

National Provider Directory

National Provider Directory

Locations

W62N281 Washington Ave
Cedarburg, WI 53012
Phone (262) 334-4340

W63N541 Hanover Ave
Cedarburg, WI 53012
Phone (262) 375-2195

Practitioners & affiliated clinicians

Practitioners 21

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.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1155340800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1225040926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W63N541 HANOVER AVE",
            "city": "CEDARBURG",
            "state": "WI",
            "postal_code": "530121917",
            "telephone_number": "262-375-2195",
            "fax_number": "262-375-2273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W63N541 HANOVER AVE",
            "city": "CEDARBURG",
            "state": "WI",
            "postal_code": "530121917",
            "telephone_number": "262-375-2195",
            "fax_number": "262-375-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CEDARBURG PHYSICAL THERAPY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GOLDBECK",
        "authorized_official_first_name": "BRANDON",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "262-375-2195",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.P.T."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "86687",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedarburg, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.