NPIMap

Organization Active NPI

Miracle Physical Therapy and Rehab Specialists LLC

  • Physical Therapist
  • Oak Creek, WI
National Provider Identifier
1679742191
Registry record updated May 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
4072024 Issued in WI
Legal business name
MIRACLE PHYSICAL THERAPY AND REHAB SPECIALISTS LLC
Practice address
2333 W Ryan Rd
Oak Creek, WI 53154-4322
Phone
(877) 552-2996
NPI assigned
Feb 28, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 18, 2010

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

Authorized official

Name
Larry Briand, PTNPI 1275573198
Title
Owner
Phone
(877) 852-2996

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X 4072024 WI Primary

Addresses

Primary practice location

2333 W Ryan Rd
Oak Creek, WI 53154-4322

Mailing address

PO Box 3497
Sturtevant, WI 53177-0300
Phone (877) 552-2996

National Provider Directory

National Provider Directory

Locations

2333 W Ryan Rd
Oak Creek, WI 53154
Phone (414) 973-1550

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1204156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1274140800000",
    "number": "1679742191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3497",
            "city": "STURTEVANT",
            "state": "WI",
            "postal_code": "531770300",
            "telephone_number": "877-552-2996",
            "fax_number": "866-245-8064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2333 W RYAN RD",
            "city": "OAK CREEK",
            "state": "WI",
            "postal_code": "531544322",
            "telephone_number": "877-552-2996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIRACLE PHYSICAL THERAPY AND REHAB SPECIALISTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-28",
        "last_updated": "2010-05-18",
        "status": "A",
        "authorized_official_last_name": "BRIAND",
        "authorized_official_first_name": "LARRY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "877-852-2996",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "4072024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Creek, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.