NPIMap

Organization Active NPI

Nissenbaum and Schleusner Pro Physical Therapy LLC

  • Physical Therapy Clinic/Center
  • Mazomanie, WI
National Provider Identifier
1871291823
Registry record updated Feb 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
NISSENBAUM AND SCHLEUSNER PRO PHYSICAL THERAPY LLC
Practice address
711 Etc Dr
Mazomanie, WI 53560-9832
Phone
(608) 413-0550
Fax
(608) 413-0552
NPI assigned
Feb 20, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2023

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

Authorized official

Name
Angela Webb-Buffington
Title
Business Office Manager
Phone
(608) 413-0550

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

711 Etc Dr
Mazomanie, WI 53560-9832

Mailing address

1118 Main St Ste a
Cross Plains, WI 53528-9477
Phone (608) 413-0550

Other names 1

  • PRO Physical Therapy - ETC Mazomanie Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Nissenbaum and Schleusner Pro Physical Therapy LLC10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

Locations

711 Etc Dr
Mazomanie, WI 53560
Phone (608) 413-0550

NPI Registry JSON

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

{
    "created_epoch": "1676851200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676851200000",
    "number": "1871291823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1118 MAIN ST STE A",
            "city": "CROSS PLAINS",
            "state": "WI",
            "postal_code": "535289477",
            "telephone_number": "608-413-0550",
            "fax_number": "608-413-0552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 ETC DR",
            "city": "MAZOMANIE",
            "state": "WI",
            "postal_code": "535609832",
            "telephone_number": "608-413-0550",
            "fax_number": "608-413-0552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NISSENBAUM AND SCHLEUSNER PRO PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-20",
        "last_updated": "2023-02-20",
        "certification_date": "2023-02-20",
        "status": "A",
        "authorized_official_last_name": "WEBB-BUFFINGTON",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_title_or_position": "BUSINESS OFFICE MANAGER",
        "authorized_official_telephone_number": "608-413-0550"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PRO Physical Therapy - ETC Mazomanie",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mazomanie, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2023; 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.