NPIMap

Organization Active NPI

Back on Track Physical Therapy, LLC

  • Physical Therapy Clinic/Center
  • Oconomowoc, WI
National Provider Identifier
1720052798
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
BACK ON TRACK PHYSICAL THERAPY, LLC
Practice address
W359N5002 Brown St
Suite B
Oconomowoc, WI 53066-3366
Phone
(262) 560-4200
NPI assigned
Feb 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Jill Johnston, PTNPI 1194740696
Title
Owner
Phone
(262) 366-9340

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 Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

W359N5002 Brown St
Suite B
Oconomowoc, WI 53066-3366

Mailing address

1622 Tallgrass Circle
Waukesha, WI 53188

National Provider Directory

National Provider Directory

Locations

W359N5002 Brown St
Ste B
Oconomowoc, WI 53066
Phone (262) 366-9340

Practitioners & affiliated clinicians

Practitioners 2

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": "1139961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1720052798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1622 TALLGRASS CIRCLE",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "53188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W359N5002 BROWN ST",
            "address_2": "SUITE B",
            "city": "OCONOMOWOC",
            "state": "WI",
            "postal_code": "530663366",
            "telephone_number": "262-560-4200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BACK ON TRACK PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JOHNSTON",
        "authorized_official_first_name": "JILL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "262-366-9340",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oconomowoc, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.