Active NPI
Joshua S. Fangman, PT, DPT
- Physical Therapist
- Salem, WI
National Provider Identifier
1386056869
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 12730-24
- Practice address
- 25250 75TH St
Salem, WI 53168-8705 - Phone
- (262) 843-4200
- Fax
- (262) 843-4578
- NPI assigned
- Jun 2, 2014
- Last updated
- Dec 5, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 12730-24 | WI | Primary |
Addresses
Primary practice location
25250 75TH St
Salem, WI 53168-8705
Mailing address
3048 Momentum PL
Chicago, IL 60689-5330
Phone (262) 657-0222
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Accelerated Rehabilitation Center of Kenosha LTD | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Athletico Physical Therapy
- Physical Therapist
- Oak Brook, IL
- NPI 1649566951
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1401667200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1449273600000",
"number": "1386056869",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3048 MOMENTUM PL",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606895330",
"telephone_number": "262-657-0222",
"fax_number": "262-657-7190"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25250 75TH ST",
"city": "SALEM",
"state": "WI",
"postal_code": "531688705",
"telephone_number": "262-843-4200",
"fax_number": "262-843-4578"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FANGMAN",
"first_name": "JOSHUA",
"middle_name": "S.",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-06-02",
"last_updated": "2015-12-05",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WI",
"license": "12730-24",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Salem, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.