Individual provider Active NPI

Alyssa Unteriner

  • Physical Therapist
  • La Crosse, WI
National Provider Identifier
1164902052
Registry record updated Feb 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
14438-24 Issued in WI
Practice address
1500 Green Bay St
La Crosse, WI 54601-6455
Phone
(608) 784-8125
NPI assigned
Aug 20, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2020007690 MO
Physical Therapist 225100000X 14438-24 WI Primary

Addresses

Primary practice location

1500 Green Bay St
La Crosse, WI 54601-6455

Mailing address

4328 Maryland Ave Apt 3
Saint Louis, MO 63108-2776
Phone (906) 361-9918

Other practice location 1

1320 S Green Bay Rd
Mount Pleasant, WI 53406-4402
Phone (262) 886-3431

Other practice location 2

4400 Clayton Ave
Saint Louis, MO 63110-1624
Phone (314) 432-3600

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
2020007690MOMDPhysical Therapist
14438-24WIMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1534723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612828800000",
    "number": "1164902052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4328 MARYLAND AVE APT 3",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631082776",
            "telephone_number": "906-361-9918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 GREEN BAY ST",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546016455",
            "telephone_number": "608-784-8125"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1320 S Green Bay Rd",
            "address_purpose": "LOCATION",
            "city": "Mount Pleasant",
            "state": "WI",
            "postal_code": "534064402",
            "country_code": "US",
            "telephone_number": "262-886-3431",
            "fax_number": "262-886-3954",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4400 Clayton Ave",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631101624",
            "country_code": "US",
            "telephone_number": "314-432-3600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "UNTERINER",
        "first_name": "ALYSSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-20",
        "last_updated": "2021-02-09",
        "certification_date": "2021-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2020007690",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "14438-24",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Crosse, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2021; 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.