NPIMap

Organization Active NPI

Fox Valley Physical Therapy & Wellness Clinic, Inc.

  • Physical Therapy Clinic/Center
  • Oshkosh, WI
National Provider Identifier
1497733513
Registry record updated May 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
FOX VALLEY PHYSICAL THERAPY & WELLNESS CLINIC, INC.
Practice address
909 S Washburn St
Oshkosh, WI 54904-8051
Phone
(920) 235-8966
NPI assigned
Jan 9, 2006
Last updated
May 19, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 19, 2008

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

Authorized official

Name
Steven Paul Sobojinski, O.T.R.NPI 1851367098
Title
President/Occupational Therapist
Phone
(920) 235-8966

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary
Durable Medical Equipment & Medical Supplies 332B00000X

Addresses

Primary practice location

909 S Washburn St
Oshkosh, WI 54904-8051

Mailing address

909 S Washburn St
Oshkosh, WI 54904-8051
Phone (920) 235-8966

Other identifiers 1

IdentifierTypeStateIssuer
40417900MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040629000344 WI Part B Supplier - Clinic/Group Practice 9638155732 Receives reassigned benefits from 5 practitioners
Practice locations: Oshkosh, WI

National Provider Directory

National Provider Directory

Locations

909 S Washburn St
Oshkosh, WI 54904
Phone (920) 235-8966

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1136764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211155200000",
    "number": "1497733513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 S WASHBURN ST",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549048051",
            "telephone_number": "920-235-8966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 S WASHBURN ST",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549048051",
            "telephone_number": "920-235-8966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOX VALLEY PHYSICAL THERAPY & WELLNESS CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-09",
        "last_updated": "2008-05-19",
        "status": "A",
        "authorized_official_last_name": "SOBOJINSKI",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "PRESIDENT/OCCUPATIONAL THERAPIST",
        "authorized_official_telephone_number": "920-235-8966",
        "authorized_official_credential": "O.T.R."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40417900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oshkosh, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2008; 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.