Individual provider Active NPI

Anthony N Friese, PT

  • Physical Therapist
  • Marinette, WI
National Provider Identifier
1952418329
Registry record updated Dec 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
4002 Issued in WI
Practice address
3200 Shore Dr
Marinette, WI 54143-4292
Phone
(715) 735-3187
Fax
(715) 735-7072
NPI assigned
Aug 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 4002 WI Primary

Addresses

Primary practice location

3200 Shore Dr
Marinette, WI 54143-4292

Mailing address

3200 Shore Dr
Marinette, WI 54143-4292
Phone (715) 735-3187

Other identifiers 1

IdentifierTypeStateIssuer
40227600MedicaidWI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050308000600 WI Practitioner - Physical Therapist in Private Practice 6204880776 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Aspirus Wausau Hospital, Inc. CurrentSince Mar 21, 2022 Accepting new patients
Aspirus Wausau Hospital, Inc. CurrentSince Mar 21, 2022 Accepting new patients
Aspirus Medical Group, Inc. CurrentSince Mar 21, 2022 Accepting new patients
Aspirus Medical Group, Inc. CurrentSince Mar 21, 2022 Accepting new patients
Aspirus Wausau Hospital, Inc. Current Accepting new patients
Aspirus Medical Group, Inc. Current Accepting new patients
Northern Lights Clinic SC Past Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

333 Pine Ridge Blvd
Wausau, WI 54401
Phone (715) 847-2160

425 Pine Ridge Blvd
Ste 200
Wausau, WI 54401
Phone (715) 847-0075

3402 Howland Ave
Ste 100
Weston, WI 54476
Phone (715) 355-5701

4005 Community Center Dr
Weston, WI 54476
Phone (715) 241-5400

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292889600000",
    "number": "1952418329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 SHORE DR",
            "city": "MARINETTE",
            "state": "WI",
            "postal_code": "541434292",
            "telephone_number": "715-735-3187",
            "fax_number": "715-735-7072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 SHORE DR",
            "city": "MARINETTE",
            "state": "WI",
            "postal_code": "541434292",
            "telephone_number": "715-735-3187",
            "fax_number": "715-735-7072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRIESE",
        "first_name": "ANTHONY",
        "middle_name": "N",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-23",
        "last_updated": "2010-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "4002",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40227600",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marinette, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2010; 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.