NPIMap

Organization Active NPI

Forward Physical Therapy LLC

  • Physical Therapist
  • Edgerton, WI
National Provider Identifier
1942774252
Registry record updated Mar 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
FORWARD PHYSICAL THERAPY LLC
Practice address
102 W Fulton St
Edgerton, WI 53534-1839
Phone
(920) 265-6192
NPI assigned
Jan 20, 2019
Last updated
Mar 6, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2026

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

Authorized official

Name
Kristen WellenkotterNPI 1679027221
Title
Co-Owner
Phone
(920) 265-6192

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Primary

Addresses

Primary practice location

102 W Fulton St
Edgerton, WI 53534-1839

Mailing address

102 W Fulton St
Edgerton, WI 53534-1839

Other practice location 1

6250 Nesbitt Rd Ste 500
Fitchburg, WI 53719-1948
Phone (608) 561-7733

Other identifiers 2

IdentifierTypeStateIssuer
100059717MedicaidWI
1649610809MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190422002285 WI Part B Supplier - Physical/Occupational Therapy Group in Private Practice 9032451117 Receives reassigned benefits from 8 practitioners
Practice locations: Edgerton, WI; Fitchburg, WI

National Provider Directory

National Provider Directory

Locations

102 W Fulton St
Edgerton, WI 53534
Phone (608) 290-5883

6111 Cottonwood Dr
Fitchburg, WI 53719
Phone (608) 561-7733

6250 Nesbitt Rd
Ste 500
Fitchburg, WI 53719
Phone (608) 561-7733

Practitioners & affiliated clinicians

Practitioners 9

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": "1547942400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1772755200000",
    "number": "1942774252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 W FULTON ST",
            "city": "EDGERTON",
            "state": "WI",
            "postal_code": "535341839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 W FULTON ST",
            "city": "EDGERTON",
            "state": "WI",
            "postal_code": "535341839",
            "telephone_number": "920-265-6192"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6250 Nesbitt Rd Ste 500",
            "address_purpose": "LOCATION",
            "city": "Fitchburg",
            "state": "WI",
            "postal_code": "537191948",
            "country_code": "US",
            "telephone_number": "608-561-7733",
            "fax_number": "608-561-7763",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "FORWARD PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-20",
        "last_updated": "2026-03-06",
        "certification_date": "2026-03-06",
        "status": "A",
        "authorized_official_last_name": "WELLENKOTTER",
        "authorized_official_first_name": "KRISTEN",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "920-265-6192"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100059717",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1649610809",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edgerton, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.