Neuro Advantage Rehabilitation, LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

NEURO ADVANTAGE REHABILITATION, LLC

Practice address

13200 Globe Dr Ste 206
Mount Pleasant, WI 53177-1615

Phone

(262) 497-8099

NPI assigned

Jan 24, 2022

Organization subpart

No

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

Authorized official

Name

Elizabeth Olley, OTRNPI 1881346609

Title

Owner

Phone

(262) 497-8099

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Locations

Practitioners 5

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

• Elizabeth A Olley

  • Occupational Therapist
  • Mount Pleasant, WI
  • NPI 1881346609
  Medicare reassignment Care Compare group NPD Authorized official
• Anika Johnson, PT, DPT, NCS

  • Physical Therapist
  • Mount Pleasant, WI
  • NPI 1841030541
  Medicare reassignment Care Compare group NPD
• Yvonne Elizabeth Petersen-Zich, M.S.

  • Speech-Language Pathologist
  • Greenfield, WI
  • NPI 1144369216
  Medicare reassignment Care Compare group NPD
• Robyn Patricia Kolosovsky Sabich

  • Speech-Language Pathologist
  • Marshfield, WI
  • NPI 1407020142
  Medicare reassignment Care Compare group NPD
• Megan Spain, PT

  • Physical Therapist
  • Mount Pleasant, WI
  • NPI 1760133169
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1642982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645660800000",
    "number": "1477205227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 CEDARWOOD CT",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534022603",
            "telephone_number": "262-497-8099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13200 GLOBE DR STE 206",
            "city": "MOUNT PLEASANT",
            "state": "WI",
            "postal_code": "531771615",
            "telephone_number": "262-497-8099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEURO ADVANTAGE REHABILITATION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-24",
        "last_updated": "2022-02-24",
        "certification_date": "2022-02-24",
        "status": "A",
        "authorized_official_last_name": "OLLEY",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "262-497-8099",
        "authorized_official_credential": "OTR"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225XP0019X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist, Physical Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1881346609",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melora Lindsay Nelmark, LMT
• David Eugene Nelson, DDS
• Kelly Nicole Nelson, NP
• Stephanie Nelson, LAT, ATC
• Randall S Nemerovski, MD
• Jack Conor Neylon
• Tran Nguyen
• Lateasha Nicole, SAC
• Mary Nilles, PT
• Sarantuya Nisler, APNP

• Physical Therapist in Mount Pleasant, WI
• Providers in Mount Pleasant, WI by specialty
• Physical Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2022; 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.