Active NPI
Michael Ray Newby, PHYSICAL THERAPIST
- Physical Therapist
- Black River Falls, WI
National Provider Identifier
1417913237
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 4840
- Practice address
- 9 Main St
Black River Falls, WI 54615-1795 - Phone
- (715) 670-0310
- Fax
- (715) 670-0315
- NPI assigned
- Apr 21, 2006
- Last updated
- Dec 1, 2021
- 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 | 4840 | WI | Primary |
Addresses
Primary practice location
9 Main St
Black River Falls, WI 54615-1795
Mailing address
1200 Oakleaf Way Ste B
Altoona, WI 54720-2245
Phone (715) 839-9266
Other practice location 1
1200 Oakleaf Way Ste B
Altoona, WI 54720-2245
Phone (715) 839-9266
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 40263400 | Medicaid | WI |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4840 | WI | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145577600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1638316800000",
"number": "1417913237",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1200 OAKLEAF WAY STE B",
"city": "ALTOONA",
"state": "WI",
"postal_code": "547202245",
"telephone_number": "715-839-9266",
"fax_number": "715-839-8761"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9 MAIN ST",
"city": "BLACK RIVER FALLS",
"state": "WI",
"postal_code": "546151795",
"telephone_number": "715-670-0310",
"fax_number": "715-670-0315"
}
],
"practiceLocations": [
{
"address_1": "1200 Oakleaf Way Ste B",
"address_purpose": "LOCATION",
"city": "Altoona",
"state": "WI",
"postal_code": "547202245",
"country_code": "US",
"telephone_number": "715-839-9266",
"fax_number": "715-839-8761",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "NEWBY",
"first_name": "MICHAEL",
"middle_name": "RAY",
"name_prefix": "Mr.",
"credential": "PHYSICAL THERAPIST",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-21",
"last_updated": "2021-12-01",
"certification_date": "2021-12-01",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WI",
"license": "4840",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "40263400",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Black River Falls, WI
- Lori Jean Mohring, MS, LPC, SAC
- Lindsay Marie Morgan, M.S. CF-SLP
- Shawn R Nadeau, RN, BSN
- Ashley Napiwocki, PHARMD
- Roxann Kay Nedrelo, P.T.
- Mary Clare Nordahl, CRNA
- Northland Hearing Centers, Inc. (Better Hearing Centre)
- Northwest Journey - Black River Falls
- Shelby M Nykiel, MD
- Cosmas Okpalaebube, PHARMACIST
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 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.