NPIMap

Organization Active NPI

Eagle P-T

Doing business as Eagle Physical Therapy

  • Physical Therapist
  • Greenfield, WI
National Provider Identifier
1811104193
Registry record updated Jun 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1436024 Issued in WI
Legal business name
EAGLE P-T
Doing business as
Eagle Physical Therapy
Practice address
3920 S 120TH St
Greenfield, WI 53228-1882
Phone
(414) 546-2667
NPI assigned
May 17, 2007
Last updated
Jun 20, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2008

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

Authorized official

Name
Mr. Dennis Sobush, PTNPI 1003943572
Title
Owner
Phone
(414) 546-2667

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1436024 WI Primary

Addresses

Primary practice location

3920 S 120TH St
Greenfield, WI 53228-1882

Mailing address

3920 S 120TH St
Greenfield, WI 53228

Other names 1

  • Eagle Physical Therapy Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1179360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213920000000",
    "number": "1811104193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3920 S 120TH ST",
            "city": "GREENFIELD",
            "state": "WI",
            "postal_code": "53228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3920 S 120TH ST",
            "city": "GREENFIELD",
            "state": "WI",
            "postal_code": "532281882",
            "telephone_number": "414-546-2667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAGLE P-T",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-17",
        "last_updated": "2008-06-20",
        "status": "A",
        "authorized_official_last_name": "SOBUSH",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "414-546-2667",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "1436024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eagle Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Greenfield, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 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.