ACTRA REHABILITATION ASSOCIATES INC (NPI# 1740255611) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740255611 |
| Entity Type | Organization |
| Organization Name | ACTRA REHABILITATION ASSOCIATES INC |
| Other Organization Name | NOVACARE PROSTHETICS & ORTHOTICS |
| Practice Address |
7201 Green Bay Rd Kenosha WI 53142-3522 |
| Mailing Address |
7201 Green Bay Rd Kenosha WI 53142-3532 |
| Practice Telephone | 2626971160 |
| Practice Fax Number | 2626971652 |
| Mailing Telephone | 2626971160 |
| Mailing Fax Number | 2626971652 |
| Enumeration Date | 2006-02-22 |
| Last Update Date | 2018-10-22 |
| Authorized Official Name | MICHAEL TARVIN (VP & SECRETARY) |
| Authorized Official Telephone | 7179721100 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 335E00000X | Prosthetic/Orthotic Supplier | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 41790600 | 05 |
| Other Name | Type Code |
|---|---|
| NovaCare Prosthetics & Orthotics | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881654622 | Actra Rehabilitation Associates Inc | Prosthetic/Orthotic Supplier | 829 S Green Bay Rd, Racine, WI 53406-4058 | 2006-03-24 |
| 1073588992 | Actra Rehabilitation Associates Inc | Prosthetic/Orthotic Supplier | 1931 S Washburn St, Oshkosh, WI 54904-7247 | 2006-02-22 |
| 1679548846 | Actra Rehabilitation Associates Inc | Prosthetic/Orthotic Supplier | 525 E Division St, Suite 104, Fond Du Lac, WI 54935-3747 | 2006-02-21 |
| 1760467823 | Actra Rehabilitation Associates Inc | Prosthetic/Orthotic Supplier | 10700 W Burleigh St, Milwaukee, WI 53222-3310 | 2005-12-13 |
| 1831164706 | Actra Rehabilitation Associates Inc | Prosthetic/Orthotic Supplier | 2727 W Cleveland Ave, Milwaukee, WI 53215-2908 | 2006-02-22 |
| 1659346526 | Actra Rehabilitation Associates Inc | Prosthetic/Orthotic Supplier | 6514 Odana Rd, Madison, WI 53719-1124 | 2006-02-22 |
| Street Address |
7201 GREEN BAY RD |
| City | KENOSHA |
| State | WI |
| Zip Code | 53142-3522 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114929064 | Southport Rehab Associates, Inc | Clinic/Center | 7201 Green Bay Rd, Kenosha, WI 53142-3522 | 2005-08-11 |
| 1245610658 | Alwin A Diaz | Nurse Practitioner | 7201 Green Bay Rd, Kenosha, WI 53142-3532 | 2015-06-02 |
| 1245650837 | Ms. Elle Huck, Pta | Physical Therapy Assistant | 7201 Green Bay Rd, Kenosha, WI 53142-3532 | 2014-04-22 |
| 1295984151 | Pamela M Hileman | Physical Therapy Assistant | 7201 Green Bay Rd, Kenosha, WI 53142-3532 | 2008-09-16 |
| 1154492668 | Gs Miceli Dpm, Sc | Podiatrist | 7201 Green Bay Rd, Suite A, Kenosha, WI 53142-3532 | 2006-11-13 |
| 1548369283 | Shelley K Rogers | Physical Therapy Assistant | 7201 Green Bay Rd, Kenosha, WI 53142-3522 | 2006-09-21 |
| 1407959711 | Karen Lynne Tenuta | Physical Therapist | 7201 Green Bay Rd, Kenosha, WI 53142-3532 | 2006-09-06 |
| 1679585145 | Kim M Parrett | Physical Therapy Assistant | 7201 Green Bay Rd, Kenosha, WI 53142-3522 | 2006-08-13 |
| 1619943354 | Giuseppe S Miceli | Podiatrist | 7201 Green Bay Rd, Suite A, Kenosha, WI 53142-3532 | 2006-02-23 |
| 1467441410 | Michael A. Hansen | Physical Therapist | 7201 Green Bay Rd, Kenosha, WI 53142-3522 | 2005-10-20 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588297816 | Caring Hearts Home Health Care | In Home Supportive Care | 6021-57th Ave, Suite C103, Kenosha, WI 53142 | 2020-02-14 |
| 1144785395 | Michael L Wrzesinski | Counselor | 4109 67th Street, Kenosha, WI 53142 | 2019-02-01 |
| 1720538499 | David Smith | Counselor | 10900 67th Street, Kenosha, WI 53142 | 2016-10-06 |
| 1326404641 | Smile Doctors Ltd | Dentist | 7003 39th Ave, Kenosha, WI 53142 | 2016-01-04 |
| 1225409485 | Antonia Marie Decker | Physician Assistant | 10400 75th St. Ste 204, Kenosha, WI 53142 | 2015-10-14 |
| 1780060582 | Joshua Haas | Pharmacist | 7701 Green Bay Road, Kenosha, IL 53142 | 2015-08-04 |
| 1811379225 | Dana Mary Stout | Registered Nurse | 7401 104th Avenue, Suite 110, Comprehensive Orthopaedics, S.c., Kenosha, WI 53142 | 2015-06-22 |
| 1669815569 | Joshua Knute Elson | Radiology | 6811 118th Ave, Kenosha, WI 53142 | 2013-04-10 |
| 1356610166 | Michael J Gallo | Pharmacist | 7535 North Greenbay Rd, Kenosha, WI 53142 | 2011-12-22 |
| 1720357999 | Orest Carnevale | Registered Nurse | 7316 155th Ct, Kenosha, WI 53142 | 2011-12-18 |
| Find all providers in zip 53142 | ||||
| Taxonomy Code | 335E00000X |
| Grouping | Suppliers |
| Classification | Prosthetic/Orthotic Supplier |
| An organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition. |
| Notes: Source: American Board for Certification in Orthotics, Prosthetics, and Pedorthics, Inc. [7/1/2010: modified, 7/1/2013: modified] Additional Resources: American Board for Certification in Orthotics, Prosthetics and Pedorthics, Inc., www.abcop.org and Board of Certification/Accreditation, International, www.bocusa.org. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285908624 | Reichert Prosthetics & Orthotics, LLC | Prosthetic/Orthotic Supplier | 5027 Green Bay Rd Ste 124, Kenosha, WI 53144-1771 | 2012-03-02 |
| 1689091316 | William T Whalen Iv | Prosthetic/Orthotic Supplier | 5027 Green Bay Rd, Suite 124, Kenosha, WI 53144-1771 | 2014-03-19 |
| 1467592758 | Chiappetta Shoes Inc | Prosthetic/Orthotic Supplier | 6821 39th Ave, Kenosha, WI 53142-7127 | 2007-02-07 |
| 1508862129 | Reichert & Kelsey Prosthetics Orthotics LLC | Prosthetic/Orthotic Supplier | 5027 Green Bay Rd, Ste 124, Kenosha, WI 53144-1771 | 2005-06-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255932604 | Cassie Mae Mathis | Prosthetic/Orthotic Supplier | W1643 Greiner Rd, Freedom, WI 54130-7943 | 2020-11-03 |
| 1649648973 | Nordstrom | Prosthetic/Orthotic Supplier | 2424 N Mayfair Rd, Wauwatosa, WI 53226-1410 | 2015-09-03 |
| 1841698834 | Srt Prosthetics & Orthotics LLC | Prosthetic/Orthotic Supplier | 5220 S 27th St., Milwaukee, WI 53221 | 2014-12-08 |
| 1073807475 | Ralph's Shoes | Prosthetic/Orthotic Supplier | 336 Water St, Eau Claire, WI 54703-6132 | 2011-06-02 |
| 1982904769 | Better Balance LLC | Prosthetic/Orthotic Supplier | 2629 E Clairemont Ave, Eau Claire, WI 54701-6726 | 2010-10-27 |
| 1861718744 | Ripon Medical Center | Prosthetic/Orthotic Supplier | 165 W Huron St, Berlin, WI 54923-1590 | 2010-04-16 |
| 1225352172 | Hickok Rehab Services LLC | Prosthetic/Orthotic Supplier | 314 N Washington St, Thorp, WI 54771-9531 | 2010-03-22 |
| 1376866954 | Hickok Rehab Services LLC | Prosthetic/Orthotic Supplier | 831 Dallas St, Chetek, WI 54728-5811 | 2010-03-10 |
| 1124356993 | Natural Tresses LLC | Prosthetic/Orthotic Supplier | 2011 N Richmond St, Appleton, WI 54911-2771 | 2009-12-05 |
| 1356571509 | Fox River Pedorthics, LLC | Prosthetic/Orthotic Supplier | 222b N Milwaukee St, Waterford, WI 53185-4312 | 2009-07-22 |
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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.