Active NPI
Ryan Pollert
- Physical Therapy Assistant
- Stanley, WI
National Provider Identifier
1659345460
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 317-019
- Practice address
- 1120 Pine St
Stanley, WI 54768-0220 - Phone
- (715) 644-6181
- Fax
- (715) 644-6183
- NPI assigned
- Feb 16, 2006
- 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 Therapy Assistant | 225200000X | 317-019 | WI | Primary |
Addresses
Primary practice location
1120 Pine St
Stanley, WI 54768-0220
Mailing address
1120 Pine St
PO Box 220
Stanley, WI 54768-0220
Phone (715) 644-6181
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 |
|---|---|---|---|
| 317-019 | WI | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140048000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1659345460",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1120 PINE ST",
"address_2": "PO BOX 220",
"city": "STANLEY",
"state": "WI",
"postal_code": "547680220",
"telephone_number": "715-644-6181",
"fax_number": "715-644-6183"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1120 PINE ST",
"city": "STANLEY",
"state": "WI",
"postal_code": "547680220",
"telephone_number": "715-644-6181",
"fax_number": "715-644-6183"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POLLERT",
"first_name": "RYAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-16",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "WI",
"license": "317-019",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stanley, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.