NPIMap

Organization Active NPI

Innovations Rehabilitation, SC

  • Occupational Therapist
  • Sparta, WI
National Provider Identifier
1891842035
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
4061 - 026 Issued in WI
Legal business name
INNOVATIONS REHABILITATION, SC
Practice address
501 W Wisconsin St
Sparta, WI 54656-2332
Phone
(608) 269-0555
Fax
(608) 269-6570
NPI assigned
Jan 3, 2007
Last updated
Sep 11, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Mr. Robert A Wiedl, PT
Title
Owner,President
Phone
(608) 269-0555

Specialties & licenses 11

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 3162-024 WI
Physical Therapist 225100000X 4419 - 024 WI
Physical Therapist 225100000X 9813 - 024 WI
Physical Therapist 225100000X 4051 - 024 WI
Physical Therapy Assistant 225200000X 92 - 019 WI
Physical Therapy Assistant 225200000X 798 - 019 WI
Physical Therapy Assistant 225200000X 44 - 019 WI
Physical Therapy Assistant 225200000X 817 - 019 WI
Occupational Therapist 225X00000X 4281 - 026 WI
Occupational Therapist 225X00000X 3666 - 026 WI
Occupational Therapist 225X00000X 4061 - 026 WI Primary

Addresses

Primary practice location

501 W Wisconsin St
Sparta, WI 54656-2332

Mailing address

501 W Wisconsin St
Sparta, WI 54656-2332
Phone (608) 269-0555

Other identifiers 1

IdentifierTypeStateIssuer
41220800MedicaidWI

National Provider Directory

National Provider Directory

Locations

501 W Wisconsin St
Sparta, WI 54656
Phone (608) 269-0555

Practitioners & affiliated clinicians

Practitioners 10

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": "1167782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1891842035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 W WISCONSIN ST",
            "city": "SPARTA",
            "state": "WI",
            "postal_code": "546562332",
            "telephone_number": "608-269-0555",
            "fax_number": "608-269-6570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 W WISCONSIN ST",
            "city": "SPARTA",
            "state": "WI",
            "postal_code": "546562332",
            "telephone_number": "608-269-0555",
            "fax_number": "608-269-6570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATIONS REHABILITATION, SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-03",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "WIEDL",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER,PRESIDENT",
        "authorized_official_telephone_number": "608-269-0555",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "3162-024",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "4419 - 024",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "9813 - 024",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "4051 - 024",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WI",
            "license": "92 - 019",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WI",
            "license": "798 - 019",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WI",
            "license": "44 - 019",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WI",
            "license": "817 - 019",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "4281 - 026",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "3666 - 026",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "4061 - 026",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41220800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sparta, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.