Active NPI
John Thomas Stack, PT
- Physical Therapist
- Eau Claire, WI
National Provider Identifier
1962562686
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 3557-024
- Practice address
- 901 W Clairemont Ave
Eau Claire, WI 54701-6103 - Phone
- (715) 839-4359
- NPI assigned
- Dec 11, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 3557-024 | WI | Primary |
Addresses
Primary practice location
901 W Clairemont Ave
Eau Claire, WI 54701-6103
Mailing address
716 W Grand Ave Apt 312
Eau Claire, WI 54703-5433
Phone (715) 852-0163
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
| License | State | Type | Specialty |
|---|---|---|---|
| 3557-024 | WI | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165795200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1962562686",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "716 W GRAND AVE APT 312",
"city": "EAU CLAIRE",
"state": "WI",
"postal_code": "547035433",
"telephone_number": "715-852-0163"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "901 W CLAIREMONT AVE",
"city": "EAU CLAIRE",
"state": "WI",
"postal_code": "547016103",
"telephone_number": "715-839-4359"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STACK",
"first_name": "JOHN",
"middle_name": "THOMAS",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WI",
"license": "3557-024",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eau Claire, WI
- St Croix Hospice LLC
- Hope C. St Jean, CNP
- St Josephs Hospital of the Hospital Sisters of the 3Rd Order of St Fra
- St. Joseph'S Hospital of the Hospital Sisters of the 3Rd Order of St F
- Stable Living LLP
- Corrie Lynn Staff, RD
- Debra S Stai, CRNA
- Christina Y Stanga, MD
- James Andrew Stanga, MD
- Stangl Chiropractic & Massage Therapy LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.