SPORT & SPINE CLINIC LP (NPI# 1528004553) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528004553 |
| Entity Type | Organization |
| Organization Name | SPORT & SPINE CLINIC LP |
| Practice Address |
1021 Western Ave Suite B Mosinee WI 54455-1529 |
| Mailing Address |
1300 W Sam Houston Parkway Suite 300 Houston TX 77042 |
| Practice Telephone | 7156937727 |
| Practice Fax Number | 7156937171 |
| Mailing Telephone | 7132977000 |
| Mailing Fax Number | 7132977090 |
| Enumeration Date | 2006-06-20 |
| Last Update Date | 2019-07-10 |
| Authorized Official Name | RICHARD BINSTEIN (VP/AUTHORIZED OFFICIAL) |
| Authorized Official Telephone | 7132977000 |
| Authorized Official Credential | JD |
| 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 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497833966 | Sport & Spine Clinic Lp | Clinic/Center | 133 South Main Street, Greenwood, WI 54437 | 2006-11-01 |
| 1730265661 | Sport & Spine Clinic Lp | Clinic/Center | 604b North Division Street, Colby, WI 54421 | 2006-10-31 |
| 1346279643 | Sport & Spine Clinic Lp | Physical Therapist | 4107 Barbican Ave, Suite 260, Weston, WI 54476-4143 | 2006-07-01 |
| 1942238167 | Sport & Spine Clinic Lp | Physical Therapist | 325 S.third Avenue, Suite B, Edgar, WI 54426 | 2006-06-28 |
| 1699711630 | Sport & Spine Clinic Lp | Physical Therapist | 327 N 17th Ave, Suite 7, Wausau, WI 54401-4225 | 2006-06-20 |
| 1164894812 | Sport & Spine Clinic Lp | Clinic/Center | 503 S Cherry Ave, Suite 2, Marshfield, WI 54449-4276 | 2015-10-21 |
| 1164821591 | Sport & Spine Clinic Lp | Durable Medical Equipment & Medical Supplies | 8554 Hwy 51 N, Minocqua, WI 54548-9312 | 2014-08-21 |
| 1225270754 | Sport & Spine Clinic Lp | Durable Medical Equipment & Medical Supplies | 226831 Rib Mountain Dr, Wausau, WI 54401-3350 | 2009-03-30 |
| 1043252695 | Sport & Spine Clinic Lp | Clinic/Center | 10524 George Ave, Suite 2, Auburndale, WI 54412-9677 | 2006-06-11 |
| Street Address |
1021 WESTERN AVE SUITE B |
| City | MOSINEE |
| State | WI |
| Zip Code | 54455-1529 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013238377 | Jason Kyle Fandrey | Physical Therapist | 1021 Western Ave, Suite B, Mosinee, WI 54455-1511 | 2010-06-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104459650 | Cameron Lee Mayfield | Student in an Organized Health Care Education/Training Program | 902 Kronenwetter Drive, Apt. 9, Mosinee, WI 54455 | 2020-02-12 |
| 1477073708 | Heather Samantha Laffin | Registered Nurse | 675 Ridge Road, Trailer 214, Mosinee, WI 54455 | 2017-06-27 |
| 1497296388 | Heidi Gwidt | Registered Nurse | 2045 1/2 S. Cty. Rd. X, Mosinee, WI 54455 | 2017-03-13 |
| 1578819256 | Rebecca Lynn Deffner | Nurse Practitioner | 1881 County Trunk Xx, Mosinee, WI 54455 | 2012-07-31 |
| 1770757668 | Peoplefirst | Skilled Nursing Facility | 681 South Highway X, Mosinee, WI 54455 | 2008-04-22 |
| 1134310063 | George A Knoedler | Dentist | 1103 Pine St, Mosinee, WI 54455 | 2007-08-06 |
| 1770785388 | Diana R Michlig | Registered Nurse | 1634 Hwy B, Mosinee, WI 54455 | 2007-06-05 |
| 1558461715 | Leah J Bouton | Physical Therapist | 390 Orbiting Drive, Mosinee, WI 54455 | 2006-09-25 |
| 1578660965 | Ryan L Miller | Chiropractor | 107 Maple St, Mosinee, WI 54455 | 2006-09-20 |
| 1942307327 | Charles N Heike | Chiropractor | 107 Maple Street, Mosinee, WI 54455 | 2006-09-20 |
| Find all providers in zip 54455 | ||||
| Taxonomy Code | 261QP2000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Physical Therapy |
| Definition to come... |
| 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.