Active NPI
Shanie L Williams, PT
- Physical Therapist
- Green Bay, WI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 6505
- Practice address
- 3263 Eaton Road
Green Bay, WI 54311-8046 - Phone
- (920) 433-6700
- Fax
- (920) 433-6769
- NPI assigned
- Dec 13, 2005
- Last updated
- Dec 30, 2022
- Sex
- Female
- 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 | 6505 | WI | Primary |
Addresses
Primary practice location
3263 Eaton Road
Green Bay, WI 54311-8046
Mailing address
PO Box 22487
Green Bay, WI 54305-2487
Phone (920) 445-7210
Other practice location 1
744 S Webster Ave
Green Bay, WI 54301-3505
Phone (920) 433-7822
Other practice location 2
1970 S Ridge Rd
Green Bay, WI 54304-4125
Phone (920) 430-4888
Other practice location 3
1580 Commanche Ave
Green Bay, WI 54313-5751
Phone (920) 435-8326
Other names 1
- Shanie L Polasik
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 1992
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
744 S Webster Ave
Green Bay, WI 54301-3505
Phone (920) 433-6025
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6505 | WI | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bellin Memorial Hospital Inc | Physical Therapist | Current | Accepting new patients |
| Bellin Memorial Hospital Inc | Current | Accepting new patients | |
| Bellin Memorial Hospital | Current | Accepting new patients |
Locations
235 E Ryan St
Brillion, WI 54110
Phone (920) 756-2055
1580 Commanche Ave
Green Bay, WI 54313
Phone (920) 431-5687
2305 San Luis Pl
Green Bay, WI 54304
Phone (920) 494-2817
3263 Eaton Rd
Green Bay, WI 54311
Phone (920) 433-6000
744 S Webster Ave
Green Bay, WI 54301
Phone (920) 433-6025
575 4th St
Kewaunee, WI 54216
Phone (920) 388-4640
405 Commercial St
Seymour, WI 54165
Phone (920) 833-2318
Interoperability endpoints
- spolasik32308@direct.thedacare.org
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Bellin Health Algoma
- Rural Health Clinic/Center
- Algoma, WI
- NPI 1609838473
-
dba Occupational Health Solutions West
- General Practice Physician
- Green Bay, WI
- NPI 1629260625
-
dba Bellin Health
- Family Medicine Physician
- Green Bay, WI
- NPI 1033172390
Physical Therapist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1134432000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1672358400000",
"number": "1699750612",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 22487",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "543052487",
"telephone_number": "920-445-7210",
"fax_number": "920-445-7289"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3263 EATON ROAD",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "543118046",
"telephone_number": "920-433-6700",
"fax_number": "920-433-6769"
}
],
"practiceLocations": [
{
"address_1": "744 S Webster Ave",
"address_purpose": "LOCATION",
"city": "Green Bay",
"state": "WI",
"postal_code": "543013505",
"country_code": "US",
"telephone_number": "920-433-7822",
"fax_number": "920-433-3651",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1970 S Ridge Rd",
"address_purpose": "LOCATION",
"city": "Green Bay",
"state": "WI",
"postal_code": "543044125",
"country_code": "US",
"telephone_number": "920-430-4888",
"fax_number": "920-430-4889",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1580 Commanche Ave",
"address_purpose": "LOCATION",
"city": "Green Bay",
"state": "WI",
"postal_code": "543135751",
"country_code": "US",
"telephone_number": "920-435-8326",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WILLIAMS",
"first_name": "SHANIE",
"middle_name": "L",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-12-13",
"last_updated": "2022-12-30",
"certification_date": "2022-12-30",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WI",
"license": "6505",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "SHANIE",
"last_name": "POLASIK",
"middle_name": "L",
"credential": "PT",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Green Bay, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2022; 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.