NPIMap

Organization Active NPI

Pinnacle Physical Therapy LLC

  • Physical Therapist
  • West Bend, WI
National Provider Identifier
1316977630
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
4798 Issued in WI
Legal business name
PINNACLE PHYSICAL THERAPY LLC
Practice address
224 Butternut St
West Bend, WI 53095-4910
Phone
(262) 853-0184
Fax
(262) 241-9881
NPI assigned
Jul 3, 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
Douglas Mazur, MS PTNPI 1710097241
Title
Owner/Physical Therapist
Phone
(262) 853-0184

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 Therapist 225100000X 4798 WI Primary

Addresses

Primary practice location

224 Butternut St
West Bend, WI 53095-4910

Mailing address

224 Butternut St
West Bend, WI 53095-4910
Phone (262) 853-0184

National Provider Directory

National Provider Directory

Locations

224 Butternut St
West Bend, WI 53095
Phone (262) 853-0184

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1316977630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224 BUTTERNUT ST",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "530954910",
            "telephone_number": "262-853-0184",
            "fax_number": "262-241-9881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "224 BUTTERNUT ST",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "530954910",
            "telephone_number": "262-853-0184",
            "fax_number": "262-241-9881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINNACLE PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MAZUR",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_title_or_position": "OWNER/PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "262-853-0184",
        "authorized_official_credential": "MS PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "4798",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Bend, 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.