NPIMap

Organization Active NPI

Optimum Therapies of Rice Lake

  • Physical Therapy Clinic/Center
  • Rice Lake, WI
National Provider Identifier
1992338909
Registry record updated Jul 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
OPTIMUM THERAPIES OF RICE LAKE
Practice address
2600 S Wisconsin Ave Ste 1
Rice Lake, WI 54868-7527
Phone
(715) 236-3610
Fax
(715) 236-3615
NPI assigned
Feb 18, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2025

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

Authorized official

Name
Jodi Drake
Title
Revenue Cycle Manager
Phone
(715) 855-0408

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X
Clinic/Center 261Q00000X
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

2600 S Wisconsin Ave Ste 1
Rice Lake, WI 54868-7527

Mailing address

517 E Clairemont Ave
Eau Claire, WI 54701-6479
Phone (715) 855-0408

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200519002111 WI Part B Supplier - Physical/Occupational Therapy Group in Private Practice 3678904042 Receives reassigned benefits from 7 practitioners
1 other NPI on this enrollment
Practice locations: Barron, WI; Rice Lake, WI

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Optimum Therapies of Rice Lake2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

2600 S Wisconsin Ave
Ste 1
Rice Lake, WI 54868
Phone (715) 236-3610

1507 W Knapp St
Unit 1
Rice Lake, WI 54868
Phone (715) 236-3610

2600 S Wisconsin Ave
Rice Lake, WI 54868

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 9

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

NPI Registry JSON

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

{
    "created_epoch": "1581984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1751328000000",
    "number": "1992338909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "517 E CLAIREMONT AVE",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547016479",
            "telephone_number": "715-855-0408",
            "fax_number": "715-855-0409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 S WISCONSIN AVE STE 1",
            "city": "RICE LAKE",
            "state": "WI",
            "postal_code": "548687527",
            "telephone_number": "715-236-3610",
            "fax_number": "715-236-3615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMUM THERAPIES OF RICE LAKE",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-18",
        "last_updated": "2025-07-01",
        "certification_date": "2025-07-01",
        "status": "A",
        "authorized_official_last_name": "DRAKE",
        "authorized_official_first_name": "JODI",
        "authorized_official_title_or_position": "REVENUE CYCLE MANAGER",
        "authorized_official_telephone_number": "715-855-0408"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "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": []
}

Other providers in Rice Lake, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2025; 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.