Individual provider Active NPI

Lisa A. Hannes, P.T.

  • Physical Therapist
  • Greenfield, WI
National Provider Identifier
1033108212
Registry record updated Feb 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
6015-024 Issued in WI
Practice address
3033 W Layton Ave
Suite 102
Greenfield, WI 53221-2628
Phone
(414) 647-0033
Fax
(414) 647-0079
NPI assigned
Oct 19, 2005
Last updated
Feb 2, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 6015-024 WI Primary

Addresses

Primary practice location

3033 W Layton Ave
Suite 102
Greenfield, WI 53221-2628

Mailing address

3114 S 14TH St
Milwaukee, WI 53215-4626
Phone (414) 643-8793

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
6015WIMDGeneral Practice Dentistry
6015-024WIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Southport Rehab Associates, Inc PastSince Apr 30, 2003 Accepting new patients
Back in Action Rehabilitation, S.C. Physical Therapist PastSince May 1, 2021 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1129680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233532800000",
    "number": "1033108212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3114 S 14TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532154626",
            "telephone_number": "414-643-8793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3033 W LAYTON AVE",
            "address_2": "SUITE 102",
            "city": "GREENFIELD",
            "state": "WI",
            "postal_code": "532212628",
            "telephone_number": "414-647-0033",
            "fax_number": "414-647-0079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANNES",
        "first_name": "LISA",
        "middle_name": "A.",
        "name_prefix": "Mrs.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-19",
        "last_updated": "2009-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "6015-024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenfield, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2009; 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.