Individual provider Active NPI

Lily Simonson, PTA

  • Physical Therapy Assistant
  • Janesville, WI
National Provider Identifier
1043828213
Registry record updated Sep 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
3059 Issued in WI
Practice address
557 N Washington St
Janesville, WI 53548-2907
Phone
(608) 754-6000
Fax
(608) 755-7892
NPI assigned
Jul 14, 2020
Last updated
Sep 21, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 3059 WI Primary

Addresses

Primary practice location

557 N Washington St
Janesville, WI 53548-2907

Mailing address

557 N Washington St
Janesville, WI 53548-2907
Phone (608) 754-6000

Other practice location 1

2825 Prairie Ave
Beloit, WI 53511-1844
Phone (608) 363-5500

Other practice location 2

N2950 State Road 67
Lake Geneva, WI 53147-2655
Phone (800) 637-2901

Other practice location 3

10108 74th St
Kenosha, WI 53142-7514
Phone (262) 694-6101

Other practice location 4

217 N Main St
Edgerton, WI 53534-1613
Phone (608) 884-9431

Other practice location 5

2310 1st Center Ave
Brodhead, WI 53520-1937
Phone (608) 897-8664

Other practice location 6

725 S Janesville St
Milton, WI 53563-1775
Phone (608) 868-5800

Other practice location 7

839 N Wisconsin St
Elkhorn, WI 53121-1138
Phone (262) 741-1400

Other practice location 8

507 W Main St
Whitewater, WI 53190-1852
Phone (262) 473-0400

Other practice location 9

3524 E Milwaukee St
Janesville, WI 53546-1626
Phone (608) 756-7100

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health System Corporation Past Accepting new patients
Mercy Health System Corporation Past 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": "1594684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695254400000",
    "number": "1043828213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "557 N WASHINGTON ST",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "535482907",
            "telephone_number": "608-754-6000",
            "fax_number": "608-755-7892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "557 N WASHINGTON ST",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "535482907",
            "telephone_number": "608-754-6000",
            "fax_number": "608-755-7892"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2825 Prairie Ave",
            "address_purpose": "LOCATION",
            "city": "Beloit",
            "state": "WI",
            "postal_code": "535111844",
            "country_code": "US",
            "telephone_number": "608-363-5500",
            "fax_number": "608-363-5539",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "N2950 State Road 67",
            "address_purpose": "LOCATION",
            "city": "Lake Geneva",
            "state": "WI",
            "postal_code": "531472655",
            "country_code": "US",
            "telephone_number": "800-637-2901",
            "fax_number": "262-245-2248",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10108 74th St",
            "address_purpose": "LOCATION",
            "city": "Kenosha",
            "state": "WI",
            "postal_code": "531427514",
            "country_code": "US",
            "telephone_number": "262-694-6101",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "217 N Main St",
            "address_purpose": "LOCATION",
            "city": "Edgerton",
            "state": "WI",
            "postal_code": "535341613",
            "country_code": "US",
            "telephone_number": "608-884-9431",
            "fax_number": "608-884-7738",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2310 1st Center Ave",
            "address_purpose": "LOCATION",
            "city": "Brodhead",
            "state": "WI",
            "postal_code": "535201937",
            "country_code": "US",
            "telephone_number": "608-897-8664",
            "fax_number": "608-897-4972",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "725 S Janesville St",
            "address_purpose": "LOCATION",
            "city": "Milton",
            "state": "WI",
            "postal_code": "535631775",
            "country_code": "US",
            "telephone_number": "608-868-5800",
            "fax_number": "608-868-5858",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "839 N Wisconsin St",
            "address_purpose": "LOCATION",
            "city": "Elkhorn",
            "state": "WI",
            "postal_code": "531211138",
            "country_code": "US",
            "telephone_number": "262-741-1400",
            "fax_number": "262-741-1401",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "507 W Main St",
            "address_purpose": "LOCATION",
            "city": "Whitewater",
            "state": "WI",
            "postal_code": "531901852",
            "country_code": "US",
            "telephone_number": "262-473-0400",
            "fax_number": "262-473-0408",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3524 E Milwaukee St",
            "address_purpose": "LOCATION",
            "city": "Janesville",
            "state": "WI",
            "postal_code": "535461626",
            "country_code": "US",
            "telephone_number": "608-756-7100",
            "fax_number": "608-756-7225",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIMONSON",
        "first_name": "LILY",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-14",
        "last_updated": "2023-09-21",
        "certification_date": "2023-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WI",
            "license": "3059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Janesville, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2023; 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.