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Advanced Physical Therapy & Sports Medicine SC

Organization Active NPI Physical Medicine & Rehabilitation Physician · Appleton, WI

NPI 1407857790 · NPPES record last updated Mar 10, 2026

Key facts

NPI
1407857790
Entity type
Organization (NPI type 2)
Primary specialty
Physical Medicine & Rehabilitation Physician 208100000X
Legal business name
ADVANCED PHYSICAL THERAPY & SPORTS MEDICINE SC
Practice address
2105 E Enterprise Ave # 113
Advanced Physical Therapy
Appleton, WI 54913-7862
Phone
(920) 991-2561
Fax
(920) 991-2563
NPI assigned
Aug 9, 2005
Organization subpart
No

Authorized official

Name
Camilla Meyer
Title
Credentialing Specialist
Phone
(920) 393-2819

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Practitioners 73

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

View all 73

Medicare participation

Medicare fee-for-service enrollment
Enrolled (3 enrollments) in WI, MI

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20040514001027 WI Part B Supplier - Clinic/Group Practice 2365432903 Receives reassigned benefits from 68 practitioners
Practice locations: Appleton, WI; Weyauwega, WI; Waupaca, WI; Two Rivers, WI; Sturgeon Bay, WI; Shawano, WI; Ripon, WI; Oshkosh, WI…
O20180922000089 WI DME Supplier - Independently-Practicing Physical Therapist
DME Supplier - Independently-Practicing Occupational Therapist		 2365432903 Practice locations: Appleton, WI
O20190820000507 MI Part B Supplier - Physical/Occupational Therapy Group in Private Practice 2365432903 Receives reassigned benefits from 4 practitioners
Practice locations: Menominee, MI

National Provider Directory

Locations (25 of 26)

3841 10th St
Menominee, MI 49858
Phone (906) 352-4033

1110 10th Ave
Ste L3
Menominee, MI 49858
Phone (906) 352-4033

1688 N Casaloma Dr
Appleton, WI 54913
Phone (920) 707-5105

1100 E South River St
Appleton, WI 54915
Phone (920) 832-6760

2851 E Apple Creek Rd
Appleton, WI 54913

2105 E Enterprise Ave
Ste 120
Appleton, WI 54913

W3132 Van Roy Rd
Appleton, WI 54915
Phone (920) 731-5562

2105 E Enterprise Ave
#113
Appleton, WI 54913

355 N Peters Ave
#3A
Fond du Lac, WI 54935

355 N Peters Ave
Ste 3A
Fond du Lac, WI 54935
Phone (920) 933-5292

5000 W Champion Dr
Grand Chute, WI 54913
Phone (920) 560-1123

801 Hoffman Rd
Green Bay, WI 54301
Phone (920) 425-7140

1200 Flightway Dr
Hobart, WI 54115
Phone (920) 425-7140

225 W Kennedy Ave
Kimberly, WI 54136

924 Buffalo St
#101
Manitowoc, WI 54220

924 Buffalo St
Manitowoc, WI 54220
Phone (920) 684-8880

145 N Commercial St
Ste B
Neenah, WI 54956

145 N Commercial St
Ste 100
Neenah, WI 54956
Phone (920) 215-6225

333 W 29th Ave
Oshkosh, WI 54902

2307 Oregon St
Oshkosh, WI 54902

600 N Koeller St
Oshkosh, WI 54902
Phone (920) 292-5900

2737 Harrison St
Oshkosh, WI 54901

212 E Green Bay St
Shawano, WI 54166
Phone (715) 526-5221

2124 Kohler Memorial Dr
Ste 110A
Sheboygan, WI 53081
Phone (920) 560-3803

217 N 4th Ave
Ste 5
Sturgeon Bay, WI 54235
Phone (920) 965-4715

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 208100000X Yes
Physical Therapy Clinic/Center 261QP2000X
Durable Medical Equipment & Medical Supplies 332B00000X

Addresses

Primary practice location

2105 E Enterprise Ave # 113
Advanced Physical Therapy
Appleton, WI 54913-7862

Mailing address

2105 E Enterprise Ave Ste 113
Appleton, WI 54913-7862
Phone (920) 991-2561

Other providers in Appleton, WI

All providers in Appleton, WI · Physical Medicine & Rehabilitation Physician in Wisconsin

Sources for this page

Verify at the official NPI Registry.