NPIMap

Organization Active NPI

St Croix Therapy Inc

  • Physical Therapist
  • Hudson, WI
National Provider Identifier
1669672911
Registry record updated Aug 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
ST CROIX THERAPY INC
Practice address
742 Sterbenz Dr
Hudson, WI 54016-8327
Phone
(715) 386-2128
Fax
(715) 386-6119
NPI assigned
Jul 24, 2007
Last updated
Aug 6, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2024

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

Authorized official

Name
Amy Nasers
Title
Office Manager
Phone
(715) 386-2128

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Developmentally Disabled Services Day Training Agency 251C00000X
Physical Therapist 225100000X Primary

Addresses

Primary practice location

742 Sterbenz Dr
Hudson, WI 54016-8327

Mailing address

742 Sterbenz Dr
Hudson, WI 54016-8327
Phone (715) 386-2128

Other identifiers 1

IdentifierTypeStateIssuer
41229700MedicaidWI

Other names 1

  • Avanti Center Inc Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100203000334 WI Part B Supplier - Clinic/Group Practice 8729121413 Receives reassigned benefits from 11 practitioners
Practice locations: Hudson, WI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1185235200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722902400000",
    "number": "1669672911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "742 STERBENZ DR",
            "city": "HUDSON",
            "state": "WI",
            "postal_code": "540168327",
            "telephone_number": "715-386-2128",
            "fax_number": "715-386-6119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "742 STERBENZ DR",
            "city": "HUDSON",
            "state": "WI",
            "postal_code": "540168327",
            "telephone_number": "715-386-2128",
            "fax_number": "715-386-6119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST CROIX THERAPY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-24",
        "last_updated": "2024-08-06",
        "certification_date": "2024-08-06",
        "status": "A",
        "authorized_official_last_name": "NASERS",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "715-386-2128"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41229700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Avanti Center Inc",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Hudson, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2024; 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.