NPIMap

Organization Active NPI

Back in Action Rehabilitation, S.C.

  • Occupational Therapist
  • Fond Du Lac, WI
National Provider Identifier
1356372445
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Legal business name
BACK IN ACTION REHABILITATION, S.C.
Practice address
103 S Pioneer Rd # 100
Fond Du Lac, WI 54935-3871
Phone
(920) 922-7776
Fax
(920) 922-2938
NPI assigned
Jul 6, 2006
Last updated
Sep 11, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Sharon Wunsch
Title
Office Manager
Phone
(920) 922-7776

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X
Occupational Therapist 225X00000X Primary

Addresses

Primary practice location

103 S Pioneer Rd # 100
Fond Du Lac, WI 54935-3871

Mailing address

103 S Pioneer Rd # 100
Fond Du Lac, WI 54935-3871
Phone (920) 922-7776

Other identifiers 1

IdentifierTypeStateIssuer
40416300MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050714001044 WI Part B Supplier - Clinic/Group Practice 3577529346 Receives reassigned benefits from 11 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Fond Du Lac, WI; Kewaskum, WI; Mayville, WI; New Holstein, WI

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Back in Action Physical4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 16

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.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1356372445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 S PIONEER RD # 100",
            "city": "FOND DU LAC",
            "state": "WI",
            "postal_code": "549353871",
            "telephone_number": "920-922-7776",
            "fax_number": "920-922-2938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 S PIONEER RD # 100",
            "city": "FOND DU LAC",
            "state": "WI",
            "postal_code": "549353871",
            "telephone_number": "920-922-7776",
            "fax_number": "920-922-2938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BACK IN ACTION REHABILITATION, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-06",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "WUNSCH",
        "authorized_official_first_name": "SHARON",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "920-922-7776"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40416300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fond Du Lac, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.