Active NPI
Dennis Home, PT
- Physical Therapist
- Beloit, WI
National Provider Identifier
1275591174
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2282-024
- Practice address
- 2737 Prairie Ave
Beloit, WI 53511-2246 - Phone
- (608) 299-8181
- Fax
- (608) 299-8281
- NPI assigned
- May 2, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 2282-024 | WI | Primary |
Addresses
Primary practice location
2737 Prairie Ave
Beloit, WI 53511-2246
Mailing address
2737 Prairie Ave
Beloit, WI 53511-2246
Phone (608) 299-8181
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 40038600 | Medicaid | WI |
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)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2282-024 | WI | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146528000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1645747200000",
"number": "1275591174",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2737 PRAIRIE AVE",
"city": "BELOIT",
"state": "WI",
"postal_code": "535112246",
"telephone_number": "608-299-8181",
"fax_number": "608-299-8181"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2737 PRAIRIE AVE",
"city": "BELOIT",
"state": "WI",
"postal_code": "535112246",
"telephone_number": "608-299-8181",
"fax_number": "608-299-8281"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOME",
"first_name": "DENNIS",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-02",
"last_updated": "2022-02-25",
"certification_date": "2021-10-20",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WI",
"license": "2282-024",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "40038600",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Beloit, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.