NPIMap

Organization Active NPI

Midwest Physical Therapy, Inc

  • Physical Therapist
  • Bloomer, WI
National Provider Identifier
1811015274
Registry record updated Dec 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
MIDWEST PHYSICAL THERAPY, INC
Practice address
1731 17TH Ave
Bloomer, WI 54724-1512
Phone
(715) 568-4669
Fax
(715) 568-4673
NPI assigned
Mar 26, 2007
Last updated
Dec 16, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2014

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

Authorized official

Name
Mr. James Price, PTNPI 1518174192
Title
Physical Therapist Owner
Phone
(715) 568-4669

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU Primary
Occupational Therapist 225X00000X NU
Speech-Language Pathologist 235Z00000X NU

Addresses

Primary practice location

1731 17TH Ave
Bloomer, WI 54724-1512

Mailing address

1731 17TH Ave
Bloomer, WI 54724-1512
Phone (715) 568-4669

Other identifiers 1

IdentifierTypeStateIssuer
41224700MedicaidWI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040901001332 WI Part B Supplier - Physical/Occupational Therapy Group in Private Practice 3375518202 Receives reassigned benefits from 16 practitioners
Practice locations: Bloomer, WI; Colfax, WI

National Provider Directory

National Provider Directory
Tax ID family
Midwest Physical Therapy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

110 Park Dr
Ste 100
Colfax, WI 54730
Phone (715) 568-4669

225 Bremer Ave
Ste 105
Colfax, WI 54730
Phone (715) 568-4669

Practitioners & affiliated clinicians

Practitioners 26

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.

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1418688000000",
    "number": "1811015274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1731 17TH AVE",
            "city": "BLOOMER",
            "state": "WI",
            "postal_code": "547241512",
            "telephone_number": "715-568-4669",
            "fax_number": "715-568-4673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1731 17TH AVE",
            "city": "BLOOMER",
            "state": "WI",
            "postal_code": "547241512",
            "telephone_number": "715-568-4669",
            "fax_number": "715-568-4673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWEST PHYSICAL THERAPY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-26",
        "last_updated": "2014-12-16",
        "status": "A",
        "authorized_official_last_name": "PRICE",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST OWNER",
        "authorized_official_telephone_number": "715-568-4669",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41224700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomer, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.