NPIMap

Organization Active NPI

Valley-Bay Therapy Inc.

  • Specialist
  • Appleton, WI
National Provider Identifier
1720138514
Registry record updated Dec 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
VALLEY-BAY THERAPY INC.
Practice address
3305 N Ballard Rd Ste C
Appleton, WI 54911-9001
Phone
(920) 735-9234
Fax
(920) 739-8288
NPI assigned
Jan 12, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2012

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

Authorized official

Name
Mr. Randall J Bricco
Title
President
Phone
(920) 735-9234

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X Primary
Occupational Therapy AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 224Z00000X
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X
Physical Therapy AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 225200000X
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X
Rehabilitation Clinic/Center 261QR0400X

Addresses

Primary practice location

3305 N Ballard Rd Ste C
Appleton, WI 54911-9001

Mailing address

3305 N Ballard Rd Ste C
Appleton, WI 54911-9001
Phone (920) 735-9234

Other identifiers 1

IdentifierTypeStateIssuer
41213100MedicaidWI

National Provider Directory

National Provider Directory

Locations

805W Elsner Rd
Appleton, WI 54913
Phone (920) 735-9234

3305 N Ballard Rd
Ste C
Appleton, WI 54911
Phone (920) 735-9234

3305 N Ballard Rd
Appleton, WI 54911
Phone (920) 735-9234

Practitioners & affiliated clinicians

Practitioners 49

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

View all 49

NPI Registry JSON

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

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1356652800000",
    "number": "1720138514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3305 N BALLARD RD STE C",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549119001",
            "telephone_number": "920-735-9234",
            "fax_number": "920-739-8288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3305 N BALLARD RD STE C",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549119001",
            "telephone_number": "920-735-9234",
            "fax_number": "920-739-8288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALLEY-BAY THERAPY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-12",
        "last_updated": "2012-12-28",
        "status": "A",
        "authorized_official_last_name": "BRICCO",
        "authorized_official_first_name": "RANDALL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "920-735-9234",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapy Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapy Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41213100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Appleton, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2012; 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.