NPIMap

Organization Active NPI

Courtney Street Rehab Clinic LTD

  • Occupational Therapist
  • Rhinelander, WI
National Provider Identifier
1780663013
Registry record updated Jun 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Legal business name
COURTNEY STREET REHAB CLINIC LTD
Practice address
203 Schiek Plaza
Rhinelander, WI 54501
Phone
(715) 369-7474
Fax
(715) 369-7475
NPI assigned
Jan 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2008

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

Authorized official

Name
Wendy P. Goldbach, MED, OTR, CHT
Title
Owner
Phone
(715) 369-7474

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225X00000X Primary

Addresses

Primary practice location

203 Schiek Plaza
Rhinelander, WI 54501

Mailing address

203 Schiek Plaza
PO Box 1161
Rhinelander, WI 54501
Phone (715) 369-7474

Other identifiers 1

IdentifierTypeStateIssuer
40547700MedicaidWI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1137110400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213142400000",
    "number": "1780663013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 SCHIEK PLAZA",
            "address_2": "PO BOX 1161",
            "city": "RHINELANDER",
            "state": "WI",
            "postal_code": "54501",
            "telephone_number": "715-369-7474",
            "fax_number": "715-369-7475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 SCHIEK PLAZA",
            "city": "RHINELANDER",
            "state": "WI",
            "postal_code": "54501",
            "telephone_number": "715-369-7474",
            "fax_number": "715-369-7475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COURTNEY STREET REHAB CLINIC LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-13",
        "last_updated": "2008-06-11",
        "status": "A",
        "authorized_official_last_name": "GOLDBACH",
        "authorized_official_first_name": "WENDY",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "715-369-7474",
        "authorized_official_credential": "MED, OTR, CHT"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40547700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rhinelander, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2008; 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.