ADVANTAGE PHYSICAL THERAPY & SPORTS REHAB, LLC (NPI# 1881773463) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881773463 |
| Entity Type | Organization |
| Organization Name | ADVANTAGE PHYSICAL THERAPY & SPORTS REHAB, LLC |
| Practice Address |
204 S Pine St Burlington WI 53105-1914 |
| Mailing Address |
3921 30th Ave Ste C Kenosha WI 53144-1957 |
| Practice Telephone | 2627679579 |
| Practice Fax Number | 2627679610 |
| Mailing Telephone | 2629255004 |
| Mailing Fax Number | 2629255001 |
| Enumeration Date | 2006-11-03 |
| Last Update Date | 2020-06-05 |
| Authorized Official Name | MR. CARMELO D TENUTA (PRESIDENT / CEO) |
| Authorized Official Telephone | 2629255002 |
| Authorized Official Credential | P.T. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | MEDICARE | 000083038 | 01 |
| WI | 40429100 | 05 |
| Street Address |
204 S PINE ST |
| City | BURLINGTON |
| State | WI |
| Zip Code | 53105-1914 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912930116 | Us Pt Therapy Services Inc. | Physical Therapist | 204 S Pine St, Burlington, WI 53105-1914 | 2006-07-09 |
| 1083863823 | Susan M. Casto | Physical Therapy Assistant | 204 S Pine St, Burlington, WI 53105-1914 | 2008-09-17 |
| 1508052937 | Kelly A. Hensler | Physical Therapist | 204 S Pine St, Burlington, WI 53105-1914 | 2007-09-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720574288 | Wisconsin Pain Management Specialists, LLC | Pain Medicine | 1050 S. Milwaukee Avenue, Suite 102, Burlington, WI 53105 | 2018-07-09 |
| 1952845679 | Jennifer Vozel | Registered Nurse | 40036 Bloomfield Rd, Burlington, WI 53105 | 2016-12-14 |
| 1356884613 | Labadie Family Dentistry, S.c. | Clinic/Center | 5019 Mormon Rd., Burlington, WI 53105 | 2016-11-18 |
| 1043654288 | Maureen Ann Mcnulty | Acupuncturist | 148 East State Street, Suite A, Burlington, WI 53105 | 2013-04-18 |
| 1003166349 | Jessica Robinson | Licensed Practical Nurse | 7656 Highland Ave, Burlington, WI 53105 | 2012-09-13 |
| 1063677334 | Douglas Armin Wild Sr. | Dentist | 2545 Partridge Wds. Ct., Burlington, WI 53105 | 2008-07-25 |
| 1346408945 | William Henry Basil | Dentist | 222 Adams St, Burlington, WI 53105 | 2008-05-30 |
| 1912108689 | Debra Jean Studey Leffelman | Midwife, Lay | 5617 Spring Valley Rd., Burlington, WI 53105 | 2007-05-30 |
| 1215142955 | Michelle Marie Mehring | Licensed Practical Nurse | 541 Kearney Rd, Burlington, WI 53105 | 2007-05-14 |
| 1003982802 | Alan Dean Meike | Chiropractor | 196 W Chestnut Street, Burlington, WI 53105 | 2006-11-27 |
| Find all providers in zip 53105 | ||||
| Taxonomy Code | 261QP2000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Physical Therapy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366063943 | Talk of The Town, LLC | Clinic/Center | 149 Hildred Dr, Burlington, VT 05401-3692 | 2020-05-05 |
| 1093222028 | Burlington Pt | Clinic/Center | 39 Birchcliff Pkwy, Burlington, VT 05401-4901 | 2017-12-28 |
| 1235162462 | Chequest Rehabilitation | Clinic/Center | 2850 Mount Pleasant St, Suite 104, Burlington, IA 52601-2002 | 2006-07-09 |
| 1780141887 | Great River Physicians and Clinics, Inc | Clinic/Center | 2750 Mount Pleasant St Ste 104, Burlington, IA 52601-2171 | 2019-02-25 |
| 1558758573 | Pike Creek Enterprises, LLC | Clinic/Center | 598 Milwaukee Ave, Burlington, WI 53105-1251 | 2015-04-16 |
| 1194078576 | Inspired Physical Rehab, LLC | Clinic/Center | 281 Cambridge St Ste 101, Burlington, MA 01803-2529 | 2012-10-22 |
| 1356508576 | Us Regional Occupational Health II of New Jersey PC | Clinic/Center | 368 Lakehurst Rd, Ste 206, Burlington, NJ 08080 | 2008-05-16 |
| 1033398441 | Schroeder Physical Therapy Services, P.C. | Clinic/Center | 3211 Division St Ste 3, Burlington, IA 52601-1692 | 2007-11-01 |
| 1497944540 | Quality Physical Therapy, Inc. P.s. | Clinic/Center | 1838 S Burlington Blvd, Burlington, WA 98233 | 2007-10-15 |
| 1982618393 | Commonwealth Rehabilitation & Sports Medicine Psc | Clinic/Center | 5874 Veterans Way, Burlington, KY 41005-8824 | 2006-07-28 |
| Find all providers in BURLINGTON | ||||
| City | BURLINGTON |
| Zip Code | 53105 |
Please comment or provide details below to improve the information on ADVANTAGE PHYSICAL THERAPY & SPORTS REHAB, LLC.
| 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.