Bauer Physical Therapy LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

5173024 Issued in WI

Legal business name

BAUER PHYSICAL THERAPY LLC

Practice address

355 N Peters Ave
Fond Du Lac, WI 54935-8258

Phone

(920) 929-9712

Fax

(920) 929-9715

NPI assigned

Apr 4, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Shane D Bauer

Title

P.T.

Phone

(920) 929-9712

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214956800000",
    "number": "1437271012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "355 N PETERS AVE",
            "city": "FOND DU LAC",
            "state": "WI",
            "postal_code": "549358258",
            "telephone_number": "920-929-9712",
            "fax_number": "920-929-9715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 N PETERS AVE",
            "city": "FOND DU LAC",
            "state": "WI",
            "postal_code": "549358258",
            "telephone_number": "920-929-9712",
            "fax_number": "920-929-9715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAUER PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-04",
        "last_updated": "2008-07-02",
        "status": "A",
        "authorized_official_last_name": "BAUER",
        "authorized_official_first_name": "SHANE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "P.T.",
        "authorized_official_telephone_number": "920-929-9712",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "WI",
            "license": "5173024",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40340300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bonnie L Bastian
• Jennifer Ann Battistine, R.N.
• Allison Batzler
• Martha W Bauder, MD
• Bauer Chiropractic, LLC
• Hattie Rose Bauer
• Shane D Bauer, P.T.
• Shayne Michael Bauer, DC
• Jennifer Nichole Baumeister
• Amy A Bayer, LCSW

• Physical Therapy Clinic/Center in Fond Du Lac, WI
• Providers in Fond Du Lac, WI by specialty
• Physical Therapy Clinic/Center in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2008; 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.