Weber Physical Therapy, LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

12288-24 Issued in WI

Legal business name

WEBER PHYSICAL THERAPY, LLC

Practice address

13445 Tosca CT
Elm Grove, WI 53122-1343

Phone

(612) 220-5361

NPI assigned

Aug 22, 2015

Organization subpart

No

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

Authorized official

Name

Kyle Weber, PTNPI 1366694788

Title

Owner

Phone

(612) 220-5361

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Locations

Practitioners 2

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

• Kyle P Weber, PT

  • Physical Therapist
  • Elm Grove, WI
  • NPI 1366694788

  WI

  Medicare reassignment NPD Authorized official
• Kathleen E Beccavin, DPT

  • Physical Therapist
  • Elm Grove, WI
  • NPI 1497480347
  NPD (past)

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

{
    "created_epoch": "1440201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1440201600000",
    "number": "1386011682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13445 TOSCA CT",
            "city": "ELM GROVE",
            "state": "WI",
            "postal_code": "531221343",
            "telephone_number": "612-220-5361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13445 TOSCA CT",
            "city": "ELM GROVE",
            "state": "WI",
            "postal_code": "531221343",
            "telephone_number": "612-220-5361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEBER PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-22",
        "last_updated": "2015-08-22",
        "status": "A",
        "authorized_official_last_name": "WEBER",
        "authorized_official_first_name": "KYLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "612-220-5361",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "WI",
            "license": "12288-24",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kou Vang
• Joan A. Vansloun, MD
• Village of Elm Grove
• Walgreen Co
• Anna M Weaver, LCSW
• Anna Sylvia Weber, PSYD
• Kyle P Weber, PT
• Robyn Michelle Welk-Richards, PHD, MSW, LCSW, CEDS
• Amanda Lee Westerlund, IT
• Whyoga Inc

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2015; 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.