Pike Creek Enterprises, LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

5392024 Issued in WI

Legal business name

PIKE CREEK ENTERPRISES, LLC

Practice address

598 Milwaukee Ave
Burlington, WI 53105-1251

Phone

(262) 763-7591

NPI assigned

Apr 16, 2015

Organization subpart

No

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

Authorized official

Name

Andrew John Connolly, PT, OCS, FAAOMPT

Title

Owner and President

Phone

(262) 945-0024

Specialties & licenses 1

Addresses

Other names 1

• Connolly Physical Therapy Doing business as

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

{
    "created_epoch": "1429142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1429142400000",
    "number": "1558758573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "598 MILWAUKEE AVE",
            "city": "BURLINGTON",
            "state": "WI",
            "postal_code": "531051251",
            "telephone_number": "262-763-7591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "598 MILWAUKEE AVE",
            "city": "BURLINGTON",
            "state": "WI",
            "postal_code": "531051251",
            "telephone_number": "262-763-7591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PIKE CREEK ENTERPRISES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-16",
        "last_updated": "2015-04-16",
        "status": "A",
        "authorized_official_last_name": "CONNOLLY",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "OWNER AND PRESIDENT",
        "authorized_official_telephone_number": "262-945-0024",
        "authorized_official_credential": "PT, OCS, FAAOMPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "WI",
            "license": "5392024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Connolly Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Grace Peyron, Peyorn
• Ronald Casper Pfeiffer Jr.
• Mark A Philips, D.O.
• Kathryn Elizabeth Phillips, RN
• James Patrick Pietryga, PHARMD
• Brittany L Porter, PAC
• Sara Frances Prelog, MSW
• Timothy M Pritzl, OD
• Private Healthcare Facilities
• Professional Psychological Services, SC

• Physical Therapy Clinic/Center in Burlington, WI
• Providers in Burlington, WI by specialty
• Physical Therapy Clinic/Center in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2015; 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.