NPIMap

Organization Active NPI

Rice Lake Physical Therapy and Rehab Specialists

  • Physical Therapist
  • Rice Lake, WI
National Provider Identifier
1992732598
Registry record updated Dec 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
RICE LAKE PHYSICAL THERAPY AND REHAB SPECIALISTS
Practice address
1507 W Knapp St
Rice Lake, WI 54868-1383
Phone
(877) 823-0508
Fax
(715) 236-3615
NPI assigned
Jun 27, 2006
Last updated
Dec 8, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2009

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

Authorized official

Name
Larry D Briand, MS, PT, ATCNPI 1275573198
Title
Co-Owner
Phone
(877) 552-2996

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

1507 W Knapp St
Rice Lake, WI 54868-1383

Mailing address

PO Box 3497
Sturtevant, WI 53177-0300
Phone (877) 552-2996

Other identifiers 1

IdentifierTypeStateIssuer
40423400MedicaidWI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 17

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 17

NPI Registry JSON

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

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1260230400000",
    "number": "1992732598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3497",
            "city": "STURTEVANT",
            "state": "WI",
            "postal_code": "531770300",
            "telephone_number": "877-552-2996",
            "fax_number": "866-245-8064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1507 W KNAPP ST",
            "city": "RICE LAKE",
            "state": "WI",
            "postal_code": "548681383",
            "telephone_number": "877-823-0508",
            "fax_number": "715-236-3615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RICE LAKE PHYSICAL THERAPY AND REHAB SPECIALISTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-27",
        "last_updated": "2009-12-08",
        "status": "A",
        "authorized_official_last_name": "BRIAND",
        "authorized_official_first_name": "LARRY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "877-552-2996",
        "authorized_official_credential": "MS, PT, ATC"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40423400",
            "state": "WI"
        }
    ],
    "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 Dec 8, 2009; 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.