Individual provider Active NPI

James Price

  • Physical Therapist
  • Bloomer, WI
National Provider Identifier
1518174192
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
3837-024 Issued in WI
Practice address
1402 Main St
Bloomer, WI 54724-1637
Phone
(715) 568-4669
NPI assigned
May 16, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 3837-024 WI Primary

Addresses

Primary practice location

1402 Main St
Bloomer, WI 54724-1637

Mailing address

13770 110TH St
Bloomer, WI 54724-9347
Phone (715) 568-4667

Other identifiers 1

IdentifierTypeStateIssuer
40162900MedicaidWI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040902000140 WI Practitioner - Physical Therapist in Private Practice 9032026786 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midwest Physical Therapy IncGroup PAC ID 3375518202, 6 clinicians

Practice addresses (Care Compare)

1731 17TH Ave
Bloomer, WI 54724-1512
Phone (715) 568-4669

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3837-024WIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Physical Therapy, Inc Physical Therapist CurrentSince Jun 7, 2004 Accepting new patients
Midwest Physical Therapy Inc. Current Accepting new patients

Locations

1731 17th Ave
Bloomer, WI 54724
Phone (715) 568-4669

1402 Main St
Bloomer, WI 54724
Phone (715) 568-1373

110 Park Dr
Ste 100
Colfax, WI 54730
Phone (715) 568-4669

Organizations & group practices 2

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": "1179273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1518174192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13770 110TH ST",
            "city": "BLOOMER",
            "state": "WI",
            "postal_code": "547249347",
            "telephone_number": "715-568-4667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1402 MAIN ST",
            "city": "BLOOMER",
            "state": "WI",
            "postal_code": "547241637",
            "telephone_number": "715-568-4669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRICE",
        "first_name": "JAMES",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "3837-024",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40162900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomer, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.