Individual provider Active NPI

Taylor L Wolf

  • Physical Therapist
  • Green Bay, WI
National Provider Identifier
1760222871
Registry record updated May 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
16730 Issued in WI
Practice address
1970 S Ridge Rd
Green Bay, WI 54304-4125
Phone
(920) 430-4888
NPI assigned
May 28, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 28, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 16730 WI Primary

Addresses

Primary practice location

1970 S Ridge Rd
Green Bay, WI 54304-4125

Mailing address

1544 Beachcomber Blvd
Waconia, MN 55387-1055
Phone (612) 518-8476

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240802002755 WI Practitioner - Physical Therapist in Private Practice 7517404924 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bellin Memorial Hospital IncGroup PAC ID 8820900749, 685 clinicians

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

LicenseStateTypeSpecialty
16730WIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Bellin Memorial Hospital Inc Current Accepting new patients
Bellin Memorial Hospital Inc Physical Therapist CurrentSince Jun 3, 2024 Accepting new patients
Bellin Memorial Hospital Inc Past Accepting new patients

Locations

744 S Webster Ave
Green Bay, WI 54301
Phone (920) 433-6025

1630 Commanche Ave
Green Bay, WI 54313
Phone (920) 430-4700

Interoperability endpoints

  • Direct secure messaging: twolf339878@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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1716854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716854400000",
    "number": "1760222871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1544 BEACHCOMBER BLVD",
            "city": "WACONIA",
            "state": "MN",
            "postal_code": "553871055",
            "telephone_number": "612-518-8476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1970 S RIDGE RD",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543044125",
            "telephone_number": "920-430-4888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLF",
        "first_name": "TAYLOR",
        "middle_name": "L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-05-28",
        "last_updated": "2024-05-28",
        "certification_date": "2024-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "16730",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 May 28, 2024; 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.