Impact Physical Therapy, LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

IMPACT PHYSICAL THERAPY, LLC

Practice address

485 Clinton CT
Amherst, WI 54406-9203

Phone

(715) 824-4460

Fax

(715) 824-3278

NPI assigned

Jan 9, 2019

Last updated

Dec 6, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Brett Roberts, DPTNPI 1427070622

Title

President

Phone

(715) 529-3487

Specialties & licenses 1

Addresses

Locations

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.

• Brett Roberts, DPT

  • Physical Therapist
  • Amherst, WI
  • NPI 1427070622
  NPD Authorized official

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

{
    "created_epoch": "1546992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670284800000",
    "number": "1871066233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 324",
            "city": "AMHERST",
            "state": "WI",
            "postal_code": "544060324",
            "telephone_number": "715-529-3487",
            "fax_number": "715-251-6236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "485 CLINTON CT",
            "city": "AMHERST",
            "state": "WI",
            "postal_code": "544069203",
            "telephone_number": "715-824-4460",
            "fax_number": "715-824-3278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMPACT PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-09",
        "last_updated": "2022-12-06",
        "certification_date": "2022-12-06",
        "status": "A",
        "authorized_official_last_name": "ROBERTS",
        "authorized_official_first_name": "BRETT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "715-529-3487",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2022; 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.