Ideal Physical Therapy LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

IDEAL PHYSICAL THERAPY LLC

Practice address

N69W5289 Columbia Rd
Cedarburg, WI 53012-2156

Phone

(414) 232-8382

NPI assigned

Dec 27, 2019

Organization subpart

No

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

Authorized official

Name

Greg Peter Fernandez, PT

Title

Physical Therapist

Phone

(414) 232-8382

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1577404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1577404800000",
    "number": "1245879048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N69W5289 COLUMBIA RD",
            "city": "CEDARBURG",
            "state": "WI",
            "postal_code": "530122156",
            "telephone_number": "414-232-8382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N69W5289 COLUMBIA RD",
            "city": "CEDARBURG",
            "state": "WI",
            "postal_code": "530122156",
            "telephone_number": "414-232-8382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDEAL PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-27",
        "last_updated": "2019-12-27",
        "certification_date": "2019-12-27",
        "status": "A",
        "authorized_official_last_name": "FERNANDEZ",
        "authorized_official_first_name": "GREG",
        "authorized_official_middle_name": "PETER",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "414-232-8382",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gregory G Highstrom, DC
• Rayne Elizabeth Holmson
• Hope'S Chariot, Inc.
• Megan Hucko
• Muhammad Ibrahim, RPH
• Daniel Jablonski, MD
• Therese L. Jaeckle, MSN, APNP
• Jaime D. Cabatingan, M.D.,S.C.
• Jaime D. Cabatingan, M.D.,S.C.
• Kimberly Marie Janecek, APNP

• Physical Therapy Clinic/Center in Cedarburg, WI
• Providers in Cedarburg, WI by specialty
• Physical Therapy Clinic/Center in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2019; 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.