Active NPI
Heidi A Larosa, PT
- Community Health Worker
- New Berlin, WI
National Provider Identifier
1083881601
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Worker
- License
- 5565-024
- Practice address
- 12830 W Peachtree Dr
New Berlin, WI 53151-7623 - Phone
- (414) 858-9706
- NPI assigned
- May 13, 2008
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | 5565-024 | WI | Primary |
Addresses
Primary practice location
12830 W Peachtree Dr
New Berlin, WI 53151-7623
Mailing address
12830 West Peachtree Dr
New Berlin, WI 53151
Phone (414) 858-9706
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 |
|---|---|---|---|
| 5565-024 | WI | MD | Community Health Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1210636800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1210636800000",
"number": "1083881601",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12830 WEST PEACHTREE DR",
"city": "NEW BERLIN",
"state": "WI",
"postal_code": "53151",
"telephone_number": "414-858-9706"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12830 W PEACHTREE DR",
"city": "NEW BERLIN",
"state": "WI",
"postal_code": "531517623",
"telephone_number": "414-858-9706"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAROSA",
"first_name": "HEIDI",
"middle_name": "A",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-05-13",
"last_updated": "2008-05-13",
"status": "A"
},
"taxonomies": [
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": "WI",
"license": "5565-024",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New Berlin, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.