Stacey Roberts, PHYSICAL THERAPIST

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

3946-24 Issued in WI

Practice address

13825 W Burleigh Rd
Brookfield, WI 53005-3058

Phone

(262) 754-3450

NPI assigned

Aug 22, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Smart Clinic Limited Practice

  • Physical Therapist
  • Brookfield, WI
  • NPI 1891711008
  NPD (past)

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

{
    "created_epoch": "1503360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1503360000000",
    "number": "1821514712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6650 W STATE ST # 233",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532132827",
            "telephone_number": "414-522-6153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13825 W BURLEIGH RD",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530053058",
            "telephone_number": "262-754-3450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "STACEY",
        "credential": "PHYSICAL THERAPIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-22",
        "last_updated": "2017-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "3946-24",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert M. Dhein, M.D., S.C.
• Allison Roberts
• Jamie Roberts, PSY.D.
• Kirsten Roberts
• Shayla Roberts
• Jonathan Robinson, M.D.
• Robust Sanity LLC
• Margaret Anderson Rodriguez, PH.D.
• Rachel A. Roeglin, PSY.D.
• Angela Kay Rohloff, OT

• Physical Therapist in Brookfield, WI
• Providers in Brookfield, WI by specialty
• Physical Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2017; 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.