Active NPI
Amy Goebel, PT
- Physical Therapist
- Sheboygan, WI
National Provider Identifier
1598779654
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 6380
- Practice address
- 2912 S Business Dr
Sheboygan, WI 53081-6520 - Phone
- (920) 803-2179
- Fax
- (920) 803-2203
- NPI assigned
- Jul 27, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 6380 | WI | Primary |
Addresses
Primary practice location
2912 S Business Dr
Sheboygan, WI 53081-6520
Mailing address
790 Remington Blvd
Bolingbrook, IL 60440-4909
Phone (630) 296-2223
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 40329300 | Medicaid | WI |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153958400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1474848000000",
"number": "1598779654",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "790 REMINGTON BLVD",
"city": "BOLINGBROOK",
"state": "IL",
"postal_code": "604404909",
"telephone_number": "630-296-2223",
"fax_number": "630-759-9510"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2912 S BUSINESS DR",
"city": "SHEBOYGAN",
"state": "WI",
"postal_code": "530816520",
"telephone_number": "920-803-2179",
"fax_number": "920-803-2203"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOEBEL",
"first_name": "AMY",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-27",
"last_updated": "2016-09-26",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WI",
"license": "6380",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "40329300",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sheboygan, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.