NPIMap

Organization Active NPI

Evolution Exercise & Spine Center

  • Physical Therapist
  • Pewaukee, WI
National Provider Identifier
1558306332
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
EVOLUTION EXERCISE & SPINE CENTER
Practice address
N22 W27847 Edgewater Drive
Suite 103
Pewaukee, WI 53072-5402
Phone
(262) 264-0080
Fax
(262) 264-0081
NPI assigned
Jun 17, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Patrick Ziebell
Title
Owner
Phone
(262) 896-6967

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Primary

Addresses

Primary practice location

N22 W27847 Edgewater Drive
Suite 103
Pewaukee, WI 53072-5402

Mailing address

N22W27847 Edgewater Dr
Suite 103
Pewaukee, WI 53072-5227
Phone (262) 264-0080

National Provider Directory

National Provider Directory

Locations

2329 Silvernail Rd
Pewaukee, WI 53072
Phone (262) 896-6769

N22W27847 Edgewater Dr
Pewaukee, WI 53072
Phone (262) 264-0080

N22W27847 Edgewater Dr
Ste 103
Pewaukee, WI 53072
Phone (262) 264-0080

Practitioners & affiliated clinicians

Practitioners 12

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": "1150502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1558306332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N22W27847 EDGEWATER DR",
            "address_2": "SUITE 103",
            "city": "PEWAUKEE",
            "state": "WI",
            "postal_code": "530725227",
            "telephone_number": "262-264-0080",
            "fax_number": "262-264-0081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N22 W27847 EDGEWATER DRIVE",
            "address_2": "SUITE 103",
            "city": "PEWAUKEE",
            "state": "WI",
            "postal_code": "530725402",
            "telephone_number": "262-264-0080",
            "fax_number": "262-264-0081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVOLUTION EXERCISE & SPINE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ZIEBELL",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "262-896-6967"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pewaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.