Individual provider Active NPI

Kelly A. Hensler, DPT,OCS,CSCS

  • Physical Therapist
  • Burlington, WI
National Provider Identifier
1508052937
Registry record updated Apr 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
6167024 Issued in WI
Practice address
204 S Pine St
Burlington, WI 53105-1914
Phone
(262) 767-9579
Fax
(262) 767-9610
NPI assigned
Sep 19, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 6167024 WI Primary

Addresses

Primary practice location

204 S Pine St
Burlington, WI 53105-1914

Mailing address

204 S Pine St
Burlington, WI 53105-1914
Phone (262) 767-9579

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071010000070 WI Practitioner - Physical Therapist in Private Practice 4688760416 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6167024WIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Advantage Physical Therapy & Sports Rehab, LLC Current Accepting new patients
Advantage Physical Therapy & Sports Rehab, LLC CurrentSince Oct 8, 2007 Accepting new patients
Advantage Physical Therapy & Sports Rehab, LLC CurrentSince Oct 8, 2007 Accepting new patients
Advantage Physical Therapy & Sports Rehab, LLC Past Accepting new patients

Locations

204 S Pine St
Burlington, WI 53105
Phone (262) 767-9579

600 52nd St
Ste 240
Kenosha, WI 53140
Phone (262) 656-0006

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1190160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364947200000",
    "number": "1508052937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 S PINE ST",
            "city": "BURLINGTON",
            "state": "WI",
            "postal_code": "531051914",
            "telephone_number": "262-767-9579",
            "fax_number": "262-767-9610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 S PINE ST",
            "city": "BURLINGTON",
            "state": "WI",
            "postal_code": "531051914",
            "telephone_number": "262-767-9579",
            "fax_number": "262-767-9610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENSLER",
        "first_name": "KELLY",
        "middle_name": "A.",
        "name_prefix": "Mrs.",
        "credential": "DPT,OCS,CSCS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-19",
        "last_updated": "2013-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "6167024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2013; 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.