Ellefson Therapy LTD

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

ELLEFSON THERAPY LTD

Practice address

1425 Summit Ave Ste 201
Waukesha, WI 53188-3200

Phone

(262) 542-1112

Fax

(262) 542-7476

NPI assigned

Oct 10, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Carmelo D. Tenuta, PTNPI 1144267550

Title

Presdent/Ceo

Phone

(262) 657-0222

Specialties & licenses 2

Addresses

Other identifiers 1

Practitioners 1

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

• Carmelo D Tenuta, PT

  • Physical Therapist
  • Kenosha, WI
  • NPI 1144267550
  NPD (past) Authorized official

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203033600000",
    "number": "1538256458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1425 SUMMIT AVE STE 201",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531883200",
            "telephone_number": "262-542-1112",
            "fax_number": "262-542-7476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1425 SUMMIT AVE STE 201",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531883200",
            "telephone_number": "262-542-1112",
            "fax_number": "262-542-7476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELLEFSON THERAPY LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-10",
        "last_updated": "2008-02-15",
        "status": "A",
        "authorized_official_last_name": "TENUTA",
        "authorized_official_first_name": "CARMELO",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "PRESDENT/CEO",
        "authorized_official_telephone_number": "262-657-0222",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40412900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Waukesha, WI
• Providers in Waukesha, WI by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2008; 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.