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

Doing business as

Sport & Spine Clinic of Jefferson

Practice address

222 S Wisconsin Drive
Suite 3
Jefferson, WI 53549

Phone

(920) 699-4201

Fax

(920) 699-4204

NPI assigned

Oct 31, 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

Other names 1

• Sport & Spine Clinic of Jefferson Doing business as

Locations

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1354060800000",
    "number": "1982780813",
    "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": "222 S WISCONSIN DRIVE",
            "address_2": "SUITE 3",
            "city": "JEFFERSON",
            "state": "WI",
            "postal_code": "53549",
            "telephone_number": "920-699-4201",
            "fax_number": "920-699-4204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPORT & SPINE CLINIC OF FORT ATKINSON LIMITED PARTNERSHIP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-31",
        "last_updated": "2012-11-28",
        "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": [
        {
            "organization_name": "Sport & Spine Clinic of Jefferson",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Cynthia Carolina Sepulveda Rodriguez, APNP
• Carrie Louise Shimkus, LPC
• Samantha Rae Sims
• Lindsey Leigh Slatter
• Renee Spitzer, PHARMD
• St. Coletta of Wisconsin
• St. Coletta of Wisconsin, Inc.
• St. Marys Dean Ventures Inc.
• Sarah Emily Stewart, APNP
• Kathryn Marie Stingl, LCPC, CRC

• Physical Therapy Clinic/Center in Jefferson, WI
• Providers in Jefferson, 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 Nov 28, 2012; 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.