West Bend Physical Therapy, LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

1848-024 Issued in WI

Legal business name

WEST BEND PHYSICAL THERAPY, LLC

Practice address

279 S 17TH Ave
Suite 3
West Bend, WI 53095-3001

Phone

(262) 689-6853

Fax

(262) 335-0514

NPI assigned

Apr 28, 2011

Organization subpart

No

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

Authorized official

Name

Mr. Jeffery KreuserNPI 1497735443

Title

Owner

Phone

(262) 689-6853

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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

• Jeffery L Kreuser, LPT

  • Physical Therapist
  • West Bend, WI
  • NPI 1497735443
  NPD (past) Authorized official

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

{
    "created_epoch": "1303948800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1303948800000",
    "number": "1497046254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "279 S. 17TH AVENUE",
            "address_2": "SUITE 3",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "53095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "279 S 17TH AVE",
            "address_2": "SUITE 3",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "530953001",
            "telephone_number": "262-689-6853",
            "fax_number": "262-335-0514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST BEND PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-28",
        "last_updated": "2011-04-28",
        "status": "A",
        "authorized_official_last_name": "KREUSER",
        "authorized_official_first_name": "JEFFERY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "262-689-6853",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "WI",
            "license": "1848-024",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40121700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• West Bend Dental Center SC
• West Bend Joint School District #1
• West Bend Open MRI, LLC
• West Bend Ops, LLC
• West Bend Optical, Inc
• West Bend Surgery Center LLC
• Joni Westenberger, OT
• Jennifer T. Weston, PA-C
• Matthew M Weston, MD
• Frederick G Westreich, MD

• Physical Therapy Clinic/Center in West Bend, WI
• Providers in West Bend, 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 Apr 28, 2011; 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.