Active NPI
Christopher Wacker, PT
- Physical Therapist
- Grafton, WI
National Provider Identifier
1639943749
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 11380
- Practice address
- 215 Washington St
Grafton, WI 53024-1700 - Phone
- (262) 376-6030
- NPI assigned
- Nov 9, 2023
- Sex
- Male
- 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 | 11380 | WI | Primary |
Addresses
Primary practice location
215 Washington St
Grafton, WI 53024-1700
Mailing address
PO Box 735044
Chicago, IL 60673-5044
Phone (262) 329-2736
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11380 | WI | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1699488000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1699488000000",
"number": "1639943749",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 735044",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606735044",
"telephone_number": "262-329-2736"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "215 WASHINGTON ST",
"city": "GRAFTON",
"state": "WI",
"postal_code": "530241700",
"telephone_number": "262-376-6030"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WACKER",
"first_name": "CHRISTOPHER",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-11-09",
"last_updated": "2023-11-09",
"certification_date": "2023-11-09",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WI",
"license": "11380",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grafton, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.