Active NPI
Leah Lisowski
- Student in an Organized Health Care Education/Training Program
- Jackson, WI
National Provider Identifier
1013711191
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 3896 Mayfield Rd
Jackson, WI 53037-9762 - Phone
- (262) 627-0751
- NPI assigned
- Apr 1, 2025
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | |||
| Surgical Physician Assistant | 363AS0400X | |||
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
3896 Mayfield Rd
Jackson, WI 53037-9762
Mailing address
3896 Mayfield Rd
Jackson, WI 53037-9762
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1743465600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1743465600000",
"number": "1013711191",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3896 MAYFIELD RD",
"city": "JACKSON",
"state": "WI",
"postal_code": "530379762"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3896 MAYFIELD RD",
"city": "JACKSON",
"state": "WI",
"postal_code": "530379762",
"telephone_number": "262-627-0751"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LISOWSKI",
"first_name": "LEAH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-04-01",
"last_updated": "2025-04-01",
"certification_date": "2025-04-01",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": false
},
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": null,
"license": null,
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jackson, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.