Individual provider Active NPI

Bart Hebert, PT

  • Physical Therapist
  • Minocqua, WI
National Provider Identifier
1245349083
Registry record updated Apr 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2936-04 Issued in WI
Practice address
8554 Hwy 51 North
Minocqua, WI 54548
Phone
(715) 358-1929
Fax
(715) 356-4031
NPI assigned
Aug 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 2936-024 WI
Physical Therapist 225100000X 2936-04 WI Primary

Addresses

Primary practice location

8554 Hwy 51 North
Minocqua, WI 54548

Mailing address

PO Box 11
Minocqua, WI 54548-0011
Phone (715) 358-1929

Other identifiers 1

IdentifierTypeStateIssuer
40237800MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2936-04WIMDPhysical Therapist
2936-024WIMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Excelrehab & Spine Center, Inc. Physical Therapist PastSince Jan 1, 2004 Accepting new patients
Sport & Spine Clinic LP Physical Therapist Past Accepting new patients
Stratford Therapy Services, Inc. Physical Therapist Past Accepting new patients
Excelrehab & Spine Center, Inc. Physical Therapist Past Accepting new patients

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1239926400000",
    "number": "1245349083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11",
            "city": "MINOCQUA",
            "state": "WI",
            "postal_code": "545480011",
            "telephone_number": "715-358-1929",
            "fax_number": "715-356-4031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8554 HWY 51 NORTH",
            "city": "MINOCQUA",
            "state": "WI",
            "postal_code": "54548",
            "telephone_number": "715-358-1929",
            "fax_number": "715-356-4031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEBERT",
        "first_name": "BART",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2009-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "WI",
            "license": "2936-024",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "2936-04",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40237800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Minocqua, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2009; 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.