Sport & Spine Clinic of Fort Atkinson Limited Partnership

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

SPORT & SPINE CLINIC OF FORT ATKINSON LIMITED PARTNERSHIP

Practice address

1508 S Church St
Watertown, WI 53094-6404

Phone

(920) 245-3773

Fax

(920) 245-3774

NPI assigned

Aug 19, 2006

Organization subpart

No

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

Authorized official

Name

Richard Binstein, JD

Title

VP/Authorized Official

Phone

(713) 297-7000

Specialties & licenses 2

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Cynthia Sue Grudzinski, PT

  • Physical Therapist
  • Watertown, WI
  • NPI 1689639155
  NPD (past)
• Kelly Robert Lynch, PT

  • Physical Therapist
  • Watertown, WI
  • NPI 1821057258
  NPD (past)

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1458604800000",
    "number": "1962516336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 W SAM HOUSTON PKWY S",
            "address_2": "SUITE 300",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770422447",
            "telephone_number": "713-297-7000",
            "fax_number": "713-297-7090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1508 S CHURCH ST",
            "city": "WATERTOWN",
            "state": "WI",
            "postal_code": "530946404",
            "telephone_number": "920-245-3773",
            "fax_number": "920-245-3774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPORT & SPINE CLINIC OF FORT ATKINSON LIMITED PARTNERSHIP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-19",
        "last_updated": "2016-03-22",
        "status": "A",
        "authorized_official_last_name": "BINSTEIN",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "VP/AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "713-297-7000",
        "authorized_official_credential": "JD"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth C Smyczek, RD
• Victor Stephen Soderstrom, DPM
• Ronald Scott Sokovich, M.D., F.A.C.S.
• Paul Richard Sommers, DDS
• Jennifer A Soto, RN
• St. Raphael'S Home Care Services LLC
• Anna Christa Stamas, DO
• Jennifer Pauline Stamm, OTR
• Abby Stas
• Lisa M. Steffl, MS, ATR-L-BC

• Physical Therapy Clinic/Center in Watertown, WI
• Providers in Watertown, 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 Mar 22, 2016; 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.