Kelly L Wachewicz, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

10226 Issued in WI

Practice address

1400 Bellinger St
Eau Claire, WI 54703-5222

Phone

(715) 838-6499

NPI assigned

Mar 20, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kelly L Rostad Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Interoperability endpoints

• Direct secure messaging: kwachewicz23122@ehrdirect.mayoclinicmsg.org

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611792000000",
    "number": "1386769008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1510",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547021510",
            "telephone_number": "715-838-6190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 BELLINGER ST",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547035222",
            "telephone_number": "715-838-6499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WACHEWICZ",
        "first_name": "KELLY",
        "middle_name": "L",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-20",
        "last_updated": "2021-01-28",
        "certification_date": "2021-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "10226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kwachewicz23122@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "1400 Bellinger St",
            "city": "Eau Claire",
            "state": "WI",
            "country_code": "US",
            "postal_code": "547035222",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "ROSTAD",
            "middle_name": "L",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Terri Jo Volkmann, SW, SAC, CSIT
• Vop Eau Claire II LLC
• Vop Eau Claire II LLC
• Martin J Voss, MD
• Voyage Counseling
• Lucas Jay Wachewicz, P.T.
• John L Waciuma, M.D.
• John Wagenknecht Jr., LCSW
• Amanda Wagner
• Caitlin Marie Wagner

• Physical Therapist in Eau Claire, WI
• Providers in Eau Claire, WI by specialty
• Physical Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2021; 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.