Nathanael P Sorum, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

11704-24 Issued in WI

Practice address

20700 Watertown Rd Ste 100
Waukesha, WI 53186-1800

Phone

(414) 540-8821

Fax

(414) 892-5745

NPI assigned

Jul 21, 2011

Last updated

May 19, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pain Management and Treatment Center, S.C.Group PAC ID 2062315419, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Pain Management & Treatment Center, S.C.

  • Specialist
  • Milwaukee, WI
  • NPI 1750412201
  Medicare reassignment Care Compare group NPD
• Omni Family Medical SC

  • Point of Service
  • Milwaukee, WI
  • NPI 1558732339
  Medicare reassignment NPD
• Providence Family Medical Clinic S.C

  • Primary Care Clinic/Center
  • Glendale, WI
  • NPI 1861857542
  Medicare reassignment NPD
• Sport Clinic Physical Therapy Inc

  • Physical Therapist
  • Bayside, WI
  • NPI 1912918475
  Medicare reassignment NPD
• Sorum Physiotherapy, LLC

  • Physical Therapist
  • Brookfield, WI
  • NPI 1407244916
  NPD Authorized official
• Omni Family Medical SC

  • Internal Medicine Physician
  • Milwaukee, WI
  • NPI 1952852121
  NPD
• Sorum Physiotherapy

  • Physical Therapist
  • Waukesha, WI
  • NPI 1912418138
  NPD
• Sport Clinic of Greater Milwaukee

  • Physical Therapist
  • Wauwatosa, WI
  • NPI 1275628208
  NPD (past)

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

{
    "created_epoch": "1311206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652918400000",
    "number": "1871881094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5055 S 84TH ST",
            "city": "GREENDALE",
            "state": "WI",
            "postal_code": "531291006",
            "telephone_number": "414-429-3030",
            "fax_number": "414-892-5745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20700 WATERTOWN RD STE 100",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531861800",
            "telephone_number": "414-540-8821",
            "fax_number": "414-892-5745"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1134 W North Ave",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532051333",
            "country_code": "US",
            "telephone_number": "414-260-8500",
            "fax_number": "414-892-5745",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SORUM",
        "first_name": "NATHANAEL",
        "middle_name": "P",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-21",
        "last_updated": "2022-05-19",
        "certification_date": "2022-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "11704-24",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DTP",
            "identifier": "11704-24",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Corissa Sonnenfeld
• Jill Sorenson, RD, CD
• Kathryn Ann Sorenson, RN
• Sorum Physiotherapy
• Heather J Sorum, NP
• Veronica Sosa, MS LPC
• Dina Paulette Sotola, APN
• Southeastern Wi Radiation
• Barbara Janet Spain
• Thomas Speaker, PHD, LCSW, CADC III

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.