Erica Lynn Ristow
Individual provider Active NPI Physical Therapist · Grantsburg, WI
NPI 1124778899 · NPPES record last updated Jan 27, 2025
Key facts
- NPI
- 1124778899
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 22015 (WI)
- Practice address
- 257 W Saint George Ave
Grantsburg, WI 54840-7827 - Phone
- (715) 463-7253
- NPI assigned
- Mar 25, 2022
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220519000251 | WI | Practitioner - Physical Therapist in Private Practice | 0446637151 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22015 | WI | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Burnett Medical Center Inc | Current | Accepting new patients | |
| Amery Regional Medical Center, Inc. | Current |
Accepting new patients | |
| Amery Regional Medical Center, Inc. | Current |
Accepting new patients |
Locations
265 Griffin St E
Amery, WI 54001
Phone (715) 268-0301
257 W Saint George Ave
Grantsburg, WI 54840
Phone (715) 463-5353
2547 State Road 35
Luck, WI 54853
Phone (715) 472-2177
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 22015 | WI | Yes |
Addresses
Primary practice location
257 W Saint George Ave
Grantsburg, WI 54840-7827
Mailing address
265 Griffin St E
Amery, WI 54001-1439
Other providers in Grantsburg, WI
- Taylor James Paap
- Brittany Stevens Pennings
- Elizabeth Marie Petrowitz
- Rhiana Pochman
- Vesna Radivojevic
- Renae Andrea Rombach
- Marie Sarra
- School District of Grantsburg
- Janelle Joy Smestad
- Spirited Psychological Services LLC
All providers in Grantsburg, WI · Physical Therapist in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 27, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.