NPIMap

Organization Active NPI

Back in Motion Physical Therapy & Spine Center PC

  • Physical Therapist
  • Spring Grove, IL
National Provider Identifier
1972727360
Registry record updated Mar 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
70015875 Issued in IL
Legal business name
BACK IN MOTION PHYSICAL THERAPY & SPINE CENTER PC
Practice address
2900 N US Highway 12 Ste J
Spring Grove, IL 60081-8322
Phone
(815) 675-0699
Fax
(815) 675-0689
NPI assigned
Apr 13, 2007
Last updated
Mar 4, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2008

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

Authorized official

Name
Sonia M Kwapisinski, DCNPI 1932214665
Title
Owner
Phone
(815) 675-0699

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X IL
Physical Therapist 225100000X IL
Physical Therapist 225100000X 70015875 IL Primary

Addresses

Primary practice location

2900 N US Highway 12 Ste J
Spring Grove, IL 60081-8322

Mailing address

PO Box 362
2900 US Hwy 12 Suite J
Spring Grove, IL 60081-0362
Phone (815) 675-0699

Other identifiers 4

IdentifierTypeStateIssuer
1932214665OtherILINDIVIDUAL NPI
1437205325OtherILINDIVIDUAL NPI OF LPT
05632004OtherILBLUE CROSS BLUE SHIELD
1730371915OtherILINDIVIDUAL NPI OF DPT

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040712000393 IL Part B Supplier - Clinic/Group Practice 5395723811 Receives reassigned benefits from 3 practitioners
Practice locations: Spring Grove, IL

National Provider Directory

National Provider Directory

Locations

2900 N US Highway 12
Ste J
Spring Grove, IL 60081
Phone (815) 675-0699

Practitioners & affiliated clinicians

Practitioners 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1176422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204588800000",
    "number": "1972727360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 362",
            "address_2": "2900 US HWY 12 SUITE J",
            "city": "SPRING GROVE",
            "state": "IL",
            "postal_code": "600810362",
            "telephone_number": "815-675-0699",
            "fax_number": "815-675-0689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 N US HIGHWAY 12 STE J",
            "city": "SPRING GROVE",
            "state": "IL",
            "postal_code": "600818322",
            "telephone_number": "815-675-0699",
            "fax_number": "815-675-0689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BACK IN MOTION PHYSICAL THERAPY & SPINE CENTER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-13",
        "last_updated": "2008-03-04",
        "status": "A",
        "authorized_official_last_name": "KWAPISINSKI",
        "authorized_official_first_name": "SONIA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "815-675-0699",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "70015875",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1932214665",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI OF LPT",
            "identifier": "1437205325",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "05632004",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI OF DPT",
            "identifier": "1730371915",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spring Grove, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2008; 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.