Bethany Rose Kubnick, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

10223-024 Issued in WI

Practice address

3501 Cranberry Blvd
Weston, WI 54476-5213

Phone

(715) 393-1000

NPI assigned

Oct 4, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: him@marshfieldclinichealthsystem.cernerdirect.com

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.

• Marshfield Clinic Inc

  dba Marshfield Clinic Florida Teleradiology/Telehealth

  • Clinic/Center
  • Marshfield, WI
  • NPI 1952347981
  NPD
• MCHS Hospitals Inc

  dba Marshfield Medical Center

  • Clinic/Center
  • Marshfield, WI
  • NPI 1093221434
  NPD
• MCHS Hospitals Inc

  dba Marshfield Medical Center - River Region Prof Svcs

  • Clinic/Center
  • Stevens Point, WI
  • NPI 1467119784
  NPD
• MCHS Hospitals Inc

  dba Marshfield Medical Center - Eau Claire Cancer Center

  • Durable Medical Equipment & Medical Supplies
  • Eau Claire, WI
  • NPI 1558230847
  NPD

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652313600000",
    "number": "1982790465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3501 CRANBERRY BLVD",
            "city": "WESTON",
            "state": "WI",
            "postal_code": "544765213",
            "telephone_number": "715-393-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3501 CRANBERRY BLVD",
            "city": "WESTON",
            "state": "WI",
            "postal_code": "544765213",
            "telephone_number": "715-393-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUBNICK",
        "first_name": "BETHANY",
        "middle_name": "ROSE",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-04",
        "last_updated": "2022-05-12",
        "certification_date": "2022-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "10223-024",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40460100",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "him@marshfieldclinichealthsystem.cernerdirect.com",
            "affiliation": "N",
            "address_1": "3501 Cranberry Blvd",
            "city": "Weston",
            "state": "WI",
            "country_code": "US",
            "postal_code": "544765213",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Scott D Kroening, PTA
• Elizabeth Annette Kroll, PT
• Emmalee Krueger, RN
• Kylie Krueger, PTA
• Miranda Krueger, PTA
• John Martin Ryan Kuhn, MD
• Josiah Caleb Kukulka, PTA
• Sanjay Kumar, MD
• Jonathan Tyler Laack, D.O.
• Melissa Laack, COTA

• Physical Therapist in Weston, WI
• Providers in Weston, WI by specialty
• Physical Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2022; 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.