Active NPI
Erwin Lim, PT
- Physical Therapist
- Kenosha, WI
National Provider Identifier
1104030303
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 4083-024
- Practice address
- 8633 32ND Ave
Kenosha, WI 53142-5187 - Phone
- (262) 694-8300
- NPI assigned
- May 9, 2007
- Sex
- Male
- 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 Therapist | 225100000X | 4083-024 | WI | Primary |
Addresses
Primary practice location
8633 32ND Ave
Kenosha, WI 53142-5187
Mailing address
8902 Arbor Hill Dr
Racine, WI 53406-2489
Phone (262) 886-2470
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 40182600 | 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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4083-024 | WI | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178668800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1104030303",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8902 ARBOR HILL DR",
"city": "RACINE",
"state": "WI",
"postal_code": "534062489",
"telephone_number": "262-886-2470"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8633 32ND AVE",
"city": "KENOSHA",
"state": "WI",
"postal_code": "531425187",
"telephone_number": "262-694-8300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIM",
"first_name": "ERWIN",
"name_prefix": "Mr.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-09",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WI",
"license": "4083-024",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "40182600",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Kenosha, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.