Northern Door Physical Therapy & Wellness LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

NORTHERN DOOR PHYSICAL THERAPY & WELLNESS LLC

Practice address

10578 Country Walk Dr Unit 29
Sister Bay, WI 54234-9114

Phone

(920) 242-1122

NPI assigned

May 3, 2018

Last updated

May 3, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Keith Fisher, PT, DPT, OCS, MTC

Title

Physical Therapist

Phone

(920) 242-1122

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1525305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1525305600000",
    "number": "1912496019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10486 W STONY RIDGE CIR UNIT 24",
            "city": "SISTER BAY",
            "state": "WI",
            "postal_code": "542348912",
            "telephone_number": "920-242-1122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10578 COUNTRY WALK DR UNIT 29",
            "city": "SISTER BAY",
            "state": "WI",
            "postal_code": "542349114",
            "telephone_number": "920-242-1122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN DOOR PHYSICAL THERAPY & WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-03",
        "last_updated": "2018-05-03",
        "status": "A",
        "authorized_official_last_name": "FISHER",
        "authorized_official_first_name": "KEITH",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "920-242-1122",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PT, DPT, OCS, MTC"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Ernest Ludwigsen, DDS
• Paige Martin, LPTA
• Robert Edwin Morley, DC
• Northern Door Chiropractic and Wellness LLC (Northern Door Chiropractic and Wellness)
• Northern Door Dental SC
• Anna Olson, DPT
• Elizabeth Ellen Patera-Butz, LPC
• Maynard Dillon Poland, M.D.
• Lori Solberg Pothast, P.T.
• Joseph Joshua Rebhan, M.D.

• Physical Therapy Clinic/Center in Sister Bay, WI
• Providers in Sister Bay, WI by specialty
• Physical Therapy Clinic/Center in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2018; 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.