Active NPI
Benjamin A Quist, DPT CSCS
- Physical Therapist
- Grafton, WI
National Provider Identifier
1891853933
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 9499024
- Practice address
- 2020 Cheyenne CT
Grafton, WI 53024-0368 - Phone
- (262) 375-1075
- Fax
- (262) 375-4975
- NPI assigned
- Dec 4, 2006
- Last updated
- Jan 30, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 9499024 | WI | Primary |
Addresses
Primary practice location
2020 Cheyenne CT
Grafton, WI 53024-0368
Mailing address
8914 W Bonniwell
Mequon, WI 53097
Phone (414) 322-5750
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9499 | WI | MD | Pharmacist |
| 9499024 | WI | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Body Renovation Health Services, S.C. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Physical Therapy Clinic/Center
- Grafton, WI
- NPI 1023210812
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165190400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1201651200000",
"number": "1891853933",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8914 W BONNIWELL",
"city": "MEQUON",
"state": "WI",
"postal_code": "53097",
"telephone_number": "414-322-5750",
"fax_number": "262-241-5229"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2020 CHEYENNE CT",
"city": "GRAFTON",
"state": "WI",
"postal_code": "530240368",
"telephone_number": "262-375-1075",
"fax_number": "262-375-4975"
}
],
"practiceLocations": [],
"basic": {
"last_name": "QUIST",
"first_name": "BENJAMIN",
"middle_name": "A",
"name_prefix": "Mr.",
"credential": "DPT CSCS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-04",
"last_updated": "2008-01-30",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WI",
"license": "9499024",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grafton, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.