Individual provider Active NPI

Calvin Donald Thomas, P.T.

  • Physical Therapist
  • Saukville, WI
National Provider Identifier
1578841854
Registry record updated Aug 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
11814-24 Issued in WI
Practice address
516 East Green Bay Ave
Saukville, WI 53080
Phone
(262) 284-9510
Fax
(262) 284-9511
NPI assigned
Aug 3, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2011

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 11814-24 WI Primary

Addresses

Primary practice location

516 East Green Bay Ave
Saukville, WI 53080

Mailing address

516 East Green Bay Ave
Saukville, WI 53080
Phone (262) 284-9510

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11814-24WIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Riverside Physical Therapy & Pelvic Health, S.C. Physical Therapist PastSince Jul 21, 2024 Accepting new patients
Riverview Physical Therapy & Sports Medicine ,S.C. Physical Therapist PastSince Oct 1, 2002 Accepting new patients

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": "1312329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312329600000",
    "number": "1578841854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "516 EAST GREEN BAY AVE",
            "city": "SAUKVILLE",
            "state": "WI",
            "postal_code": "53080",
            "telephone_number": "262-284-9510",
            "fax_number": "262-284-9511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 EAST GREEN BAY AVE",
            "city": "SAUKVILLE",
            "state": "WI",
            "postal_code": "53080",
            "telephone_number": "262-284-9510",
            "fax_number": "262-284-9511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "CALVIN",
        "middle_name": "DONALD",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-03",
        "last_updated": "2011-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "11814-24",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saukville, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2011; 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.