NPIMap

Organization Active NPI

Stellar Rehabilitation, LLC-Willow Pointe

  • Physical Therapist
  • Verona, WI
National Provider Identifier
1841311230
Registry record updated Oct 2, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
9730-024 Issued in WI
Legal business name
STELLAR REHABILITATION, LLC-WILLOW POINTE
Practice address
1125 N Edge TRL
Verona, WI 53593-2021
Phone
(608) 845-2100
Fax
(608) 845-2101
NPI assigned
Apr 3, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2007

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

Authorized official

Name
Ms. Susan Armstrong, MPT
Title
Physical Therapist
Phone
(608) 845-2100

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X 9730-024 WI Primary
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X 3909-026 WI
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X 2089-154 WI

Addresses

Primary practice location

1125 N Edge TRL
Verona, WI 53593-2021

Mailing address

1049 N Edge TRL
Verona, WI 53593-1942
Phone (608) 845-2100

Other identifiers 1

IdentifierTypeStateIssuer
41224200MedicaidWI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040414000247 WI Part B Supplier - Physical/Occupational Therapy Group in Private Practice 6204820913 Receives reassigned benefits from 1 practitioner
8 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Verona, WI; Waunakee, WI; Middleton, WI; Madison, WI; Fitchburg, WI; Cottage Grove, WI; Deforest, WI; Belleville, WI

Other NPIs on the same Medicare enrollment 8

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191283200000",
    "number": "1841311230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1049 N EDGE TRL",
            "city": "VERONA",
            "state": "WI",
            "postal_code": "535931942",
            "telephone_number": "608-845-2100",
            "fax_number": "608-845-2101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 N EDGE TRL",
            "city": "VERONA",
            "state": "WI",
            "postal_code": "535932021",
            "telephone_number": "608-845-2100",
            "fax_number": "608-845-2101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STELLAR REHABILITATION, LLC-WILLOW POINTE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-03",
        "last_updated": "2007-10-02",
        "status": "A",
        "authorized_official_last_name": "ARMSTRONG",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "608-845-2100",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "9730-024",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "3909-026",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "WI",
            "license": "2089-154",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41224200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Verona, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2007; 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.