Liberty Star Medical LTD

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

27454-20 Issued in WI

Legal business name

LIBERTY STAR MEDICAL LTD

Practice address

1905 Center Ave
Suite 5
Janesville, WI 53546-2842

Phone

(608) 563-4213

Fax

(866) 998-1030

NPI assigned

Sep 10, 2012

Organization subpart

No

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

Authorized official

Name

Dr. David Brian Gattuso Sr., MD

Title

Physician

Phone

(608) 563-4213

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1347235200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1348099200000",
    "number": "1184973877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1905 CENTER AVE",
            "address_2": "SUITE 5",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "535462842",
            "telephone_number": "608-295-3670",
            "fax_number": "866-998-1030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1905 CENTER AVE",
            "address_2": "SUITE 5",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "535462842",
            "telephone_number": "608-563-4213",
            "fax_number": "866-998-1030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBERTY STAR MEDICAL LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-10",
        "last_updated": "2012-09-20",
        "status": "A",
        "authorized_official_last_name": "GATTUSO",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "BRIAN",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "608-563-4213",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "WI",
            "license": "27454-20",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ross L Levine, MD
• Sarah Suzan Lewellin-Cook, RDH
• Brenda K Lewis, SW
• LHBM Legacy LLC
• Angela O. Liautaud, PT
• Carrin E. Lichty, OT
• Ashley Ellen Lienhardt, PA-C
• Lifting Hearts Wellness Clinic LLC
• Anthony James Ligeski
• Ashley Kaye Liles, APNP

• Clinic/Center in Janesville, WI
• Providers in Janesville, WI by specialty
• Clinic/Center in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2012; 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.