Organization Active NPI

Freeman Leick Physical Therapy

  • Physical Therapy Clinic/Center
  • Brookfield, WI
National Provider Identifier
1619674702
Registry record updated Feb 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
FREEMAN LEICK PHYSICAL THERAPY
Practice address
285 N Janacek Rd Ste C
Brookfield, WI 53045-6102
Phone
(262) 309-4870
NPI assigned
Feb 9, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2023

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

Authorized official

Name
Melissa Leick, DPTNPI 1508147448
Title
Owner
Phone
(262) 309-4870

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

285 N Janacek Rd Ste C
Brookfield, WI 53045-6102

Mailing address

285 N Janacek Rd Ste C
Brookfield, WI 53045-6102
Phone (262) 309-4870

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230530001160 WI Part B Supplier - Physical/Occupational Therapy Group in Private Practice 8022475508 Receives reassigned benefits from 1 practitioner
Practice locations: Brookfield, WI

National Provider Directory

National Provider Directory

Locations

285 N Janacek Rd
Ste C
Brookfield, WI 53045
Phone (262) 309-4870

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1675900800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675900800000",
    "number": "1619674702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "285 N JANACEK RD STE C",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530456102",
            "telephone_number": "262-309-4870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "285 N JANACEK RD STE C",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530456102",
            "telephone_number": "262-309-4870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREEMAN LEICK PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-09",
        "last_updated": "2023-02-09",
        "certification_date": "2023-02-09",
        "status": "A",
        "authorized_official_last_name": "LEICK",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "262-309-4870",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookfield, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.