Active NPI
Rebecca Lynn Windsor, PTA
- Physical Therapy Assistant
- Black River Falls, WI
National Provider Identifier
1013074293
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 912019
- Practice address
- 711 W Adams St
Black River Falls, WI 54615-9108 - Phone
- (715) 284-1330
- Fax
- (715) 284-1398
- NPI assigned
- Jan 3, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 912019 | WI | Primary |
Addresses
Primary practice location
711 W Adams St
Black River Falls, WI 54615-9108
Mailing address
711 W Adams St
Black River Falls, WI 54615-9108
Phone (715) 284-1330
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 912019 | Other | WI | WISCONSIN LICENSE |
| 40313100 | Medicaid | WI |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 912019 | WI | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167782400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1013074293",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "711 W ADAMS ST",
"city": "BLACK RIVER FALLS",
"state": "WI",
"postal_code": "546159108",
"telephone_number": "715-284-1330",
"fax_number": "715-284-1398"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "711 W ADAMS ST",
"city": "BLACK RIVER FALLS",
"state": "WI",
"postal_code": "546159108",
"telephone_number": "715-284-1330",
"fax_number": "715-284-1398"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WINDSOR",
"first_name": "REBECCA",
"middle_name": "LYNN",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-03",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "WI",
"license": "912019",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WISCONSIN LICENSE",
"identifier": "912019",
"state": "WI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "40313100",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Black River Falls, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.