Organization Active NPI

Back in Action Rehabilitation

  • Occupational Therapist
  • New Holstein, WI
National Provider Identifier
1396946729
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Legal business name
BACK IN ACTION REHABILITATION
Practice address
1401 Milwaukee Dr
New Holstein, WI 53061
Phone
(920) 898-4440
NPI assigned
May 31, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Sharon Wunsch
Title
Office Manager
Phone
(920) 922-7776

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X Primary

Addresses

Primary practice location

1401 Milwaukee Dr
New Holstein, WI 53061

Mailing address

103 S Pioneer Rd # 100
Fond Du Lac, WI 54935-3871
Phone (920) 922-7776

Other identifiers 1

IdentifierTypeStateIssuer
40416300MedicaidWI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050714001044 WI Part B Supplier - Clinic/Group Practice 3577529346 Receives reassigned benefits from 11 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Fond Du Lac, WI; Kewaskum, WI; Mayville, WI; New Holstein, WI

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Back in Action Rehab4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

103 S Pioneer Rd
Ste 100
Fond du Lac, WI 54935
Phone (920) 922-7776

Ownership & related parties

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1180569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1396946729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 S PIONEER RD # 100",
            "city": "FOND DU LAC",
            "state": "WI",
            "postal_code": "549353871",
            "telephone_number": "920-922-7776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 MILWAUKEE DR",
            "city": "NEW HOLSTEIN",
            "state": "WI",
            "postal_code": "53061",
            "telephone_number": "920-898-4440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BACK IN ACTION REHABILITATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-31",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "WUNSCH",
        "authorized_official_first_name": "SHARON",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "920-922-7776"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40416300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Holstein, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.