Individual provider Active NPI

Cheryl Lasselle, DPT

  • Physical Therapist
  • Mount Pleasant, WI
National Provider Identifier
1003174855
Registry record updated Apr 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5876-24 Issued in WI
Practice address
2210 N Fancher Rd
Mount Pleasant, WI 53406-2051
Phone
(262) 886-1956
NPI assigned
Apr 30, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 30, 2012

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 5876-24 WI Primary
Physical Therapist 225100000X 1134039 TX
Physical Therapist 225100000X 19444 CA
Physical Therapist 225100000X 070.010640 IL
Physical Therapist 225100000X 11-01243 KS

Addresses

Primary practice location

2210 N Fancher Rd
Mount Pleasant, WI 53406-2051

Mailing address

2210 N Fancher Rd
Mount Pleasant, WI 53406-2051
Phone (262) 886-1956

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
070.010640ILMDPhysical Therapist
11-01243KSMDPhysical Therapist
1134039TXMDPhysical Therapist
5876-24WIMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1335744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335744000000",
    "number": "1003174855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2210 N FANCHER RD",
            "city": "MOUNT PLEASANT",
            "state": "WI",
            "postal_code": "534062051",
            "telephone_number": "262-886-1956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2210 N FANCHER RD",
            "city": "MOUNT PLEASANT",
            "state": "WI",
            "postal_code": "534062051",
            "telephone_number": "262-886-1956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LASSELLE",
        "first_name": "CHERYL",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-30",
        "last_updated": "2012-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "5876-24",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1134039",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "19444",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070.010640",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KS",
            "license": "11-01243",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Pleasant, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2012; 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.