Active NPI
Maxwell Wesenberg, DPT
- Physical Therapist
- Oshkosh, WI
National Provider Identifier
1649811019
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 14859-24
- Practice address
- 2970 Manor Dr
Oshkosh, WI 54904-9253 - Phone
- (920) 379-0158
- NPI assigned
- Oct 7, 2019
- 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 | 14859-24 | WI | Primary |
Addresses
Primary practice location
2970 Manor Dr
Oshkosh, WI 54904-9253
Mailing address
2970 Manor Dr
Oshkosh, WI 54904-9253
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": "1570406400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1570406400000",
"number": "1649811019",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2970 MANOR DR",
"city": "OSHKOSH",
"state": "WI",
"postal_code": "549049253"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2970 MANOR DR",
"city": "OSHKOSH",
"state": "WI",
"postal_code": "549049253",
"telephone_number": "920-379-0158"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WESENBERG",
"first_name": "MAXWELL",
"name_prefix": "Dr.",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-10-07",
"last_updated": "2019-10-07",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WI",
"license": "14859-24",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oshkosh, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.