Craig M Gorst, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5191-024 Issued in WI

Practice address

717 E Alfred St
Weyauwega, WI 54983-9024

Phone

(920) 867-3121

Fax

(920) 867-3997

NPI assigned

May 3, 2007

Last updated

Nov 9, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Rehab Arisces Home Health Services

  • Home Health Agency
  • Fond Du Lac, WI
  • NPI 1740626332
  NPD (past)
• Taylored Rehab, LLC

  • Physical Therapy Clinic/Center
  • Fond Du Lac, WI
  • NPI 1356485791

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194566400000",
    "number": "1396967501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2035 HAMILTON ST",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549011706",
            "telephone_number": "920-379-7695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "717 E ALFRED ST",
            "city": "WEYAUWEGA",
            "state": "WI",
            "postal_code": "549839024",
            "telephone_number": "920-867-3121",
            "fax_number": "920-867-3997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORST",
        "first_name": "CRAIG",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-03",
        "last_updated": "2007-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "5191-024",
            "primary": true
        },
        {
            "code": "2251G0304X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Geriatrics",
            "state": "WI",
            "license": "5191-024",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40260200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• County of Waupaca (Lakeview Manor)
• Crossroads Care Center of Weyauwega, LLC (Avina of Weyauwega)
• Michelle Ann Dean, R.N.
• Brian Domrzalski
• Extendicare Homes, Inc. (Weyauwega Health Care Center)
• Victoria Hillskotter, SLP
• Iris Health Clinic LLC
• Tatiana Jansen
• Kevin Richard Johnson, COTA
• Jana Marie Kizewski, PTA

• Physical Therapist in Weyauwega, WI
• Providers in Weyauwega, WI by specialty
• Physical Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2007; 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.