Joseph R. Waller, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

6231-024 Issued in WI

Practice address

E3277 Apple Tree LN
Waupaca, WI 54981-7580

Phone

(715) 256-0358

Fax

(715) 256-0393

NPI assigned

Jun 16, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 8

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Orthopedic and Spine Therapy of Menasha SCGroup PAC ID 8123923869, 20 clinicians

Orthopedic and Spine Therapy of New London SCGroup PAC ID 6901869411, 7 clinicians

Orthopedic and Spine Therapy of Waupaca SCGroup PAC ID 2365475878, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Orthopedic & Spine Therapy of New London, SC

  • Physical Therapy Clinic/Center
  • New London, WI
  • NPI 1437187135

  Physical Therapist, WI

  Medicare reassignment Care Compare group NPD
• Orthopedic & Spine Therapy of Waupaca SC

  • Physical Therapist
  • Waupaca, WI
  • NPI 1548298284
  Medicare reassignment Care Compare group NPD
• Orthopedic and Spine Therapy of Menasha SC

  • Physical Therapist
  • Kaukauna, WI
  • NPI 1831260611
  Medicare reassignment Care Compare group NPD
• Orthopedic & Spine Therapy of Menasha SC

  • Physical Therapist
  • Appleton, WI
  • NPI 1932136322
  NPD
• Orthopedic & Spine Therapy of New London, SC

  • Physical Therapy Clinic/Center
  • Hortonville, WI
  • NPI 1164080388

  Physical Therapist

  NPD
• Orthopedic & Spine Therapy of Oshkosh SC

  • Physical Therapist
  • Oshkosh, WI
  • NPI 1952418816
  NPD (past)

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

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372291200000",
    "number": "1689618852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 N PROVIDENCE AVE",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549138018",
            "telephone_number": "920-257-2005",
            "fax_number": "920-257-2004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "E3277 APPLE TREE LN",
            "city": "WAUPACA",
            "state": "WI",
            "postal_code": "549817580",
            "telephone_number": "715-256-0358",
            "fax_number": "715-256-0393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLER",
        "first_name": "JOSEPH",
        "middle_name": "R.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-16",
        "last_updated": "2013-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "6231-024",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40319100",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "64-07247",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MN",
            "identifier": "27F99WA",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "64-03552",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE/POPLAR",
            "identifier": "650023250",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SECURITY HEALTH PLAN",
            "identifier": "84251",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MN",
            "identifier": "42B57WA",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE/NEW LONDON",
            "identifier": "P00403685",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Baylee Lynn Voss-Plutschack
• Carol A Voss, MD
• Michelle Rene Waggoner, MS-CCC-SLP
• Jill Renee Waite, CSW
• Walgreen Co
• Steven R. Warber, PTA
• Michael Andrew Ward, M.D.
• Charles D Washington, M.D.
• Deborah Ann Wastart
• Watson Counseling Services

• All providers in Waupaca, WI
• Physical Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.