Wayne a Johansen

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

987 Issued in WI

Legal business name

WAYNE A JOHANSEN

Practice address

626 14TH St
Baraboo, WI 53913-1535

Phone

(608) 356-2334

Fax

(608) 356-2636

NPI assigned

Apr 10, 2007

Organization subpart

No

Name

Mr. Wayne A JohansenNPI 1629064126

Title

Owner/Physical Therapist

Phone

(608) 356-2334

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Wayne A Johansen, PT

  • Physical Therapist
  • Baraboo, WI
  • NPI 1629064126
  NPD (past) Authorized official
• Jamie L Bockhop, PT/LAT

  • Physical Therapist
  • Baraboo, WI
  • NPI 1083836092
  NPD (past)
• Albojay Deacon

  • Physical Therapist
  • Milwaukee, WI
  • NPI 1427495720
  NPD (past)
• Teresa Q Wolkowski, NP

  • Adult Health Nurse Practitioner
  • Baraboo, WI
  • NPI 1649228818
  NPD (past)
• Bryan Cummings, MSPT

  • Physical Therapist
  • Spokane, WA
  • NPI 1235192816
  NPD (past)

• PHYSICAL THERAPY SERVICES Doing business as

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 17, 2008.

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213660800000",
    "number": "1356564520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31",
            "city": "BARABOO",
            "state": "WI",
            "postal_code": "539130031",
            "telephone_number": "608-356-2334",
            "fax_number": "608-356-2636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "626 14TH ST",
            "city": "BARABOO",
            "state": "WI",
            "postal_code": "539131535",
            "telephone_number": "608-356-2334",
            "fax_number": "608-356-2636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAYNE A JOHANSEN",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-10",
        "last_updated": "2008-06-17",
        "status": "A",
        "authorized_official_last_name": "JOHANSEN",
        "authorized_official_first_name": "WAYNE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER/PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "608-356-2334",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "WI",
            "license": "987",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40414400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PHYSICAL THERAPY SERVICES",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Valerie Walton, BS, RBT
• Blake R Ward
• Jonathan Michael Ward, BSP, MBA
• Kaela Lee Warner
• Kelsi Watson
• Paul Benjamin Webb, OD
• Devin L Webster, MSW, APSW
• Molly Wecker, MD
• Joseph Paul Weidenbenner, L.P.C, M.A.
• Jason Welch

• All providers in Baraboo, WI
• Physical Therapy Clinic/Center in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2008; 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.