NEW LIFE PHYSICAL THERAPY & SPORTS MEDICINE (NPI# 1033522354) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033522354 |
| Entity Type | Organization |
| Organization Name | NEW LIFE PHYSICAL THERAPY & SPORTS MEDICINE |
| Practice Address |
2639 New Pinery Rd Ste 2 Portage WI 53901-1110 |
| Practice Telephone | 6087429356 |
| Mailing Telephone | 6087429356 |
| Enumeration Date | 2014-06-04 |
| Last Update Date | 2014-06-04 |
| Authorized Official Name | MARY ROSE LUCIANO (PHYSICAL THERAPIST / COO) |
| Authorized Official Telephone | 6087429356 |
| Authorized Official Credential | PT, DPT, OCS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
PTL.0012676 | CO | Ambulatory Health Care Facilities |
| Street Address |
2639 NEW PINERY RD STE 2 |
| City | PORTAGE |
| State | WI |
| Zip Code | 53901-1110 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154807691 | Nash Bell | Physical Therapist | 2639 New Pinery Rd Ste 2, Portage, WI 53901 | 2018-07-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740710748 | Robert James Corliss | Internal Medicine | St. Vincent Fmc, 140east Cook St., Portage, WI 53901 | 2017-06-13 |
| 1639328867 | Casey Jo Ambort | Speech-Language Pathologist | 626 East Slifer St, Portage, WI 53901 | 2008-09-11 |
| 1871767400 | Planned Parenthood of Wi, Inc | Non-Pharmacy Dispensing Site | 132 W. Cook St., Portage, WI 53901 | 2008-04-15 |
| 1881872158 | Marta Jean Jindra | Physical Therapist | 626 E Slifer Street, Portage, WI 53901 | 2008-02-08 |
| 1699953976 | Lana Marie Edwards | Speech-Language Pathologist | 626 East Slifer Street, Portage, WI 53901 | 2008-02-08 |
| 1134314552 | Kristina Hellenbrand | Physical Therapist | 2639 New Pinery Road, Suite 2, Portage, WI 53901 | 2007-09-10 |
| 1689727810 | Gregory Allan Bindl | Chiropractor | 2121new Pinery Rd, Portage, WI 53901 | 2007-01-19 |
| 1720149156 | Timothy J Rosin Dds Sc | Dentist | 2570 New Pinery Rd, Portage, WI 53901 | 2006-12-12 |
| 1710083779 | Currani Seubert Dental Office LLC | Dentist | 260 W Cook St, Portage, WI 53901 | 2006-09-16 |
| 1225090525 | University of Wisconsin Medical Foundation Inc | Durable Medical Equipment & Medical Supplies | 2977 Cty Hwy Cx, Portage, WI 53901 | 2006-04-04 |
| Find all providers in zip 53901 | ||||
| Taxonomy Code | 261QP2000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Physical Therapy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265776017 | Living Water Wellness and Therapy LLC | Clinic/Center | 6643 Lagoon Way, Apartment 4, Portage, IN 46368-4277 | 2012-11-17 |
| 1245242379 | Physiotherapy Associates Inc | Clinic/Center | 3275 Cooley Ct Ste 130, Portage, MI 49024-7421 | 2006-08-13 |
| 1225033202 | Select Medical Rehabilitation Clinics Inc | Clinic/Center | 6678 Us Highway 6, Portage, IN 46368-5117 | 2005-06-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093313074 | Byond Physical Therapy, LLC | Clinic/Center | 11320 W Forest Home Ave, Franklin, WI 53132-1401 | 2020-10-13 |
| 1568078780 | Streamline Physical Therapy | Clinic/Center | 5806 Crabapple Ln, Madison, WI 53711-3437 | 2020-09-22 |
| 1790311199 | Exos Wi LLC | Clinic/Center | 7044 S Ballpark Dr Ste 300, Franklin, WI 53132-6910 | 2020-03-17 |
| 1831735885 | Garvey Physical Therapy & Wellness LLC | Clinic/Center | 417 Maple Ct, Campbellsport, WI 53010-3531 | 2019-11-25 |
| 1821649088 | Impact Physical Therapy & Performance LLC | Clinic/Center | 1155 Clarity Dr, Verona, WI 53593-9318 | 2019-09-27 |
| 1427605146 | Peak Endurance | Clinic/Center | 15 N Butler St, Madison, WI 53703-4237 | 2019-08-19 |
| 1558917617 | Quad/med, LLC | Clinic/Center | N61 W23044 Harry's Way, Sussex, WI 53089 | 2019-08-14 |
| 1619521267 | Space To Be Well, LLC | Clinic/Center | 1091 Sutherland Ave, River Falls, WI 54022-7509 | 2019-07-31 |
| 1346894656 | Cornerstone Physical Therapy, LLC | Clinic/Center | 2829 County Highway I Ste 3, Chippewa Falls, WI 54729-2678 | 2019-07-25 |
| 1619437514 | Resilience Rx LLC | Clinic/Center | 4708 Graywood Ct Apt 3, Nashotah, WI 53058-9688 | 2019-03-25 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.