Individual provider Active NPI

Kimberly Schoenberger, PT

  • Physical Therapist
  • Columbus, WI
National Provider Identifier
1639623689
Registry record updated Jul 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5568-24 Issued in WI
Practice address
1515 Park Ave
Columbus, WI 53925-1618
Phone
(920) 623-2200
NPI assigned
Aug 8, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 7381 MN
Physical Therapist 225100000X 5568-24 WI Primary

Addresses

Primary practice location

1515 Park Ave
Columbus, WI 53925-1618

Mailing address

1515 Park Ave
Columbus, WI 53925-1618
Phone (920) 623-2200

Other names 1

  • Kimberly Hovda Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170725000342 WI Practitioner - Physical Therapist in Private Practice 8325318306 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Mayo Medical School, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prairie Ridge Health IncGroup PAC ID 6800791484, 70 clinicians

Practice addresses (Care Compare)

118 W Maple Ave
Beaver Dam, WI 53916-2104
Phone (920) 356-1000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7381MNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Prairie Ridge Health Inc. CurrentSince Jul 1, 2019 Accepting new patients
Prairie Ridge Health, Inc. Current Accepting new patients
Prairie Ridge Health, Inc. CurrentSince Jul 1, 2019 Accepting new patients
Olmsted Medical Center Past Accepting new patients

Locations

118 W Maple Ave
Beaver Dam, WI 53916
Phone (920) 356-1000

1515 Park Ave
Columbus, WI 53925
Phone (920) 623-1200

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/a87187e5-fe2f-447e-bf32-4eeb3954a735/

Organizations & group practices 4

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": "1470614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563494400000",
    "number": "1639623689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 PARK AVE",
            "city": "COLUMBUS",
            "state": "WI",
            "postal_code": "539251618",
            "telephone_number": "920-623-2200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 PARK AVE",
            "city": "COLUMBUS",
            "state": "WI",
            "postal_code": "539251618",
            "telephone_number": "920-623-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHOENBERGER",
        "first_name": "KIMBERLY",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-08",
        "last_updated": "2019-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "7381",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "5568-24",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "HOVDA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Columbus, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.