Michael Stimac, PTA, LAT

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

1830-19 Issued in WI

Practice address

225 Memorial Dr
Berlin, WI 54923-1243

Phone

(920) 748-9633

NPI assigned

Jun 3, 2011

Last updated

Jun 22, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1307059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466553600000",
    "number": "1316231616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1612 ROOSEVELT AVE",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549011733",
            "telephone_number": "920-573-0983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 MEMORIAL DR",
            "city": "BERLIN",
            "state": "WI",
            "postal_code": "549231243",
            "telephone_number": "920-748-9633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STIMAC",
        "first_name": "MICHAEL",
        "credential": "PTA, LAT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-03",
        "last_updated": "2016-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WI",
            "license": "1830-19",
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "WI",
            "license": "1435-39",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sean Smith, DPT
• Kimberly J Soda-Murkley, RN
• Chad Spaulding, L.A.T.
• John Sprader, DIPL. AC.
• Joseph Daniel Statz
• Emily M Strahota, PA-C
• Sue Stumpner
• Kenneth Sullivan, MD
• Supportive Learning Care
• Tina Lorene Swanke, OTR

• Physical Therapy Assistant in Berlin, WI
• Providers in Berlin, WI by specialty
• Physical Therapy Assistant in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2016; 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.