Keystone Physical Therapy LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

KEYSTONE PHYSICAL THERAPY LLC

Practice address

19265 W Capitol Dr Ste L01
Brookfield, WI 53045-2740

Phone

(262) 790-5775

Fax

(262) 790-5710

NPI assigned

Feb 1, 2007

Organization subpart

No

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

Authorized official

Name

Amy Carlson

Title

Business Manager

Phone

(262) 790-5775

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• KRC Therapy Former legal business name

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Locations

Practitioners 7

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

• Sandra Christie Moloney, P.T.

  • Physical Therapist
  • Brookfield, WI
  • NPI 1356692537
  Medicare reassignment Care Compare group NPD
• Kent Carlson, PT, MPT

  • Physical Therapist
  • Pewaukee, WI
  • NPI 1477719151
  Medicare reassignment Care Compare group
• Stephanie Helmuth, PT

  • Physical Therapist
  • Waukesha, WI
  • NPI 1558405290
  Medicare reassignment Care Compare group
• Paul W Potos, PT

  • Physical Therapist
  • Shorewood, WI
  • NPI 1487676870
  Medicare reassignment Care Compare group
• Heather Christia Teplin, PT

  • Physical Therapist
  • Grafton, WI
  • NPI 1447318951
  Medicare reassignment Care Compare group
• Scott David Heins, MS PT CSCS

  • Physical Therapist
  • Brookfield, WI
  • NPI 1932243664
  NPD (past)
• Scott E Stamn, PT

  • Physical Therapist
  • Milwaukee, WI
  • NPI 1558480574
  NPD (past)

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

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722816000000",
    "number": "1427196765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19265 W CAPITOL DR STE L01",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530452740",
            "telephone_number": "262-790-5775",
            "fax_number": "262-790-5710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19265 W CAPITOL DR STE L01",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530452740",
            "telephone_number": "262-790-5775",
            "fax_number": "262-790-5710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEYSTONE PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-01",
        "last_updated": "2024-08-05",
        "certification_date": "2024-08-05",
        "status": "A",
        "authorized_official_last_name": "CARLSON",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "262-790-5775"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "392031168010",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kpt@keystonept.com",
            "affiliation": "N",
            "endpointDescription": "Clinic Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "17045 W Capitol Dr",
            "city": "Brookfield",
            "state": "WI",
            "country_code": "US",
            "postal_code": "530052153",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kpt@keystonept.com",
            "affiliation": "N",
            "address_1": "19265 W Capitol Dr Ste L01",
            "city": "Brookfield",
            "state": "WI",
            "country_code": "US",
            "postal_code": "530452740",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "KRC Therapy",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Jennifer Lynn Kenton, PT
• Lowell H. Keppel, M.D.
• Jamya P Kersh
• Therese G. Kerwel, MD
• Kevin a. Harry, O.D.
• Samia Khan, MS. MFT, LPC
• Gaganjot Singh Khurana
• Zachary Ivan Kienol, DC
• Micaela Killinger, LPC
• Kim Tran-Wertz DDS Ms LLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2024; 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.