Lane Thomas Laclair, DPT, CSCS, NSCA-CPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

9917024 Issued in WI

Practice address

1201 Main St
Union Grove, WI 53182-1303

Phone

(262) 878-9602

Fax

(262) 878-9609

NPI assigned

May 17, 2006

Sex

Male

Sole proprietor

No

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Athletico LTD

  • Physical Therapist
  • Oak Brook, IL
  • NPI 1821085028
  Medicare reassignment NPD Physical Therapist, WI

Specialty

Physical Therapist in Private Practice

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Athletico LTD 2,187 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

86.32 of 100Reported as group

Quality

84.44

Promoting interoperability

99

Improvement activities

40

Cost

70.78

Medicare fee-for-service enrollment

Enrolled in WI

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 19, 2015.

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450483200000",
    "number": "1174576706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 MAIN ST",
            "city": "UNION GROVE",
            "state": "WI",
            "postal_code": "531821303",
            "telephone_number": "262-878-9602",
            "fax_number": "262-878-9609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 MAIN ST",
            "city": "UNION GROVE",
            "state": "WI",
            "postal_code": "531821303",
            "telephone_number": "262-878-9602",
            "fax_number": "262-878-9609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACLAIR",
        "first_name": "LANE",
        "middle_name": "THOMAS",
        "credential": "DPT, CSCS, NSCA-CPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2015-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "9917024",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40384500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Karrylyn K Kais
• Amie Koehnlein, LPC
• Simonida Kokanovic, M.D.
• Sarah Koldeway, PHARMD
• Elizabeth P Kravig, DDS
• Mary Lakomy, PTA
• Kristin Marie Lenz Galbreath, DMD
• Mary Lenz, DDS
• Geraldine Ilene Linden, LPN
• Anthony R Matoska, DPT

• All providers in Union Grove, WI
• Physical Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.