Individual provider Active NPI

Adam M. Davis, P.T.

  • Physical Therapist
  • Wauwatosa, WI
National Provider Identifier
1376587303
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5066-024 Issued in WI
Practice address
2636 N 90TH St
Wauwatosa, WI 53226-1813
Phone
(414) 763-9542
NPI assigned
Jun 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 5066-024 WI Primary

Addresses

Primary practice location

2636 N 90TH St
Wauwatosa, WI 53226-1813

Mailing address

2636 N 90TH St
Wauwatosa, WI 53226-1813

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040916000659 WI Practitioner - Physical Therapist in Private Practice 3375510407 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Body in Balance Physical Therapy, LLCGroup PAC ID 9436232105, 2 clinicians

Practice addresses (Care Compare)

560 S Industrial Dr
Hartland, WI 53029-2324
Phone (262) 369-7941

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5066-024WIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Body in Balance Physical Therapy, LLC CurrentSince Jul 1, 2003 Accepting new patients
Alta Soma Physical Therapy Physical Therapist Past Accepting new patients

Locations

560 S Industrial Dr
Hartland, WI 53029
Phone (262) 369-7941

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1376587303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2636 N 90TH ST",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532261813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2636 N 90TH ST",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532261813",
            "telephone_number": "414-763-9542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "ADAM",
        "middle_name": "M.",
        "name_prefix": "Mr.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-16",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "5066-024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wauwatosa, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.