Active NPI
David Nehls, DPT
- Physical Therapist
- Beaver Dam, WI
National Provider Identifier
1811506447
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 15013-24
- Practice address
- 626 Lake Shore Dr
Beaver Dam, WI 53916-1432 - Phone
- (920) 210-0926
- NPI assigned
- Jul 29, 2020
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 15013-24 | WI | Primary |
Addresses
Primary practice location
626 Lake Shore Dr
Beaver Dam, WI 53916-1432
Mailing address
626 Lake Shore Dr
Beaver Dam, WI 53916-1432
Phone (920) 210-0926
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15013-24 | WI | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1595980800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1595980800000",
"number": "1811506447",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "626 LAKE SHORE DR",
"city": "BEAVER DAM",
"state": "WI",
"postal_code": "539161432",
"telephone_number": "920-210-0926"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "626 LAKE SHORE DR",
"city": "BEAVER DAM",
"state": "WI",
"postal_code": "539161432",
"telephone_number": "920-210-0926"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NEHLS",
"first_name": "DAVID",
"credential": "DPT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-07-29",
"last_updated": "2020-07-29",
"certification_date": "2020-07-29",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Physical Therapist",
"state": "WI",
"license": "15013-24",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Beaver Dam, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.