NPIMap

Organization Active NPI

Back & Body Therapeutic Touch, LLC

Doing business as Back & Body Rehabilitation

  • Specialist
  • Berlin, WI
National Provider Identifier
1831289107
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
729-026 Issued in WI
Legal business name
BACK & BODY THERAPEUTIC TOUCH, LLC
Doing business as
Back & Body Rehabilitation
Practice address
147 N State St
Berlin, WI 54923-1621
Phone
(920) 229-0955
NPI assigned
Oct 14, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Tina L Swanke, OTRNPI 1063511061
Title
Owner
Phone
(920) 229-0955

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
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 729-026 WI Primary

Addresses

Primary practice location

147 N State St
Berlin, WI 54923-1621

Mailing address

N6681 County Rd N
Princeton, WI 54968-9323
Phone (920) 229-0955

Other identifiers 1

IdentifierTypeStateIssuer
40729700MedicaidWI

Other names 1

  • Back & Body Rehabilitation Doing business as

National Provider Directory

National Provider Directory

Locations

147 N State St
Berlin, WI 54923
Phone (920) 229-0955

Practitioners & affiliated clinicians

Practitioners 8

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": "1160784000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1831289107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N6681 COUNTY RD N",
            "city": "PRINCETON",
            "state": "WI",
            "postal_code": "549689323",
            "telephone_number": "920-229-0955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "147 N STATE ST",
            "city": "BERLIN",
            "state": "WI",
            "postal_code": "549231621",
            "telephone_number": "920-229-0955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BACK & BODY THERAPEUTIC TOUCH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SWANKE",
        "authorized_official_first_name": "TINA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "920-229-0955",
        "authorized_official_credential": "OTR"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "WI",
            "license": "729-026",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40729700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Back & Body Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Berlin, WI

Sources for this page

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

Verify at the official NPI Registry.