Individual provider Active NPI

Kristine Marie Greener, PTA

  • Physical Therapy Assistant
  • Chippewa Falls, WI
National Provider Identifier
1154574515
Registry record updated Oct 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
174-019 Issued in WI
Practice address
13686 85TH Ave
Chippewa Falls, WI 54729-8843
Phone
(715) 829-9729
NPI assigned
Oct 29, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2008

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 174-019 WI Primary

Addresses

Primary practice location

13686 85TH Ave
Chippewa Falls, WI 54729-8843

Mailing address

13686 85TH Ave
Chippewa Falls, WI 54729-8843
Phone (715) 829-9729

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

LicenseStateTypeSpecialty
174-019WIMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1225238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225238400000",
    "number": "1154574515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13686 85TH AVE",
            "city": "CHIPPEWA FALLS",
            "state": "WI",
            "postal_code": "547298843",
            "telephone_number": "715-829-9729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13686 85TH AVE",
            "city": "CHIPPEWA FALLS",
            "state": "WI",
            "postal_code": "547298843",
            "telephone_number": "715-829-9729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENER",
        "first_name": "KRISTINE",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-29",
        "last_updated": "2008-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WI",
            "license": "174-019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chippewa Falls, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 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.

Verify at the official NPI Registry.