Individual provider Active NPI

Stephen Edward Kessler, PTA

  • Physical Therapy Assistant
  • Hudson, WI
National Provider Identifier
1902185499
Registry record updated Aug 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
1823 Issued in WI
Practice address
742 Sterbenz Dr
Avanti Center Inc
Hudson, WI 54016-8327
Phone
(715) 386-2128
Fax
(715) 386-6119
NPI assigned
Aug 15, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 1823 WI Primary

Addresses

Primary practice location

742 Sterbenz Dr
Avanti Center Inc
Hudson, WI 54016-8327

Mailing address

742 Sterbenz Dr
Avanti Center Inc
Hudson, WI 54016-8327
Phone (715) 386-2128

Other identifiers 1

IdentifierTypeStateIssuer
1823OtherWIWISCONSIN LICENSE

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1823WIMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1313366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313366400000",
    "number": "1902185499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "742 STERBENZ DR",
            "address_2": "AVANTI CENTER INC",
            "city": "HUDSON",
            "state": "WI",
            "postal_code": "540168327",
            "telephone_number": "715-386-2128",
            "fax_number": "715-386-6119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "742 STERBENZ DR",
            "address_2": "AVANTI CENTER INC",
            "city": "HUDSON",
            "state": "WI",
            "postal_code": "540168327",
            "telephone_number": "715-386-2128",
            "fax_number": "715-386-6119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KESSLER",
        "first_name": "STEPHEN",
        "middle_name": "EDWARD",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-15",
        "last_updated": "2011-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WI",
            "license": "1823",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WISCONSIN LICENSE",
            "identifier": "1823",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hudson, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2011; 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.