Active NPI
Laurie Mollenhauer, P.T., D.P.T.
- Physical Therapist
- Oshkosh, WI
National Provider Identifier
1194910489
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 6490-024
- Practice address
- 855 N Westhaven Drive
Oshkosh, WI 54904 - Phone
- (920) 456-7100
- NPI assigned
- Sep 10, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 6490-24 | WI | |
| Physical Therapist | 225100000X | 6490-024 | WI | Primary |
Addresses
Primary practice location
855 N Westhaven Drive
Oshkosh, WI 54904
Mailing address
855 N Westhaven Drive
Oshkosh, WI 54904
Phone (920) 456-7100
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
| License | State | Type | Specialty |
|---|---|---|---|
| 6490-024 | WI | MD | Physical Therapist |
| 6490-24 | WI | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1189382400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1647475200000",
"number": "1194910489",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "855 N WESTHAVEN DRIVE",
"city": "OSHKOSH",
"state": "WI",
"postal_code": "54904",
"telephone_number": "920-456-7100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "855 N WESTHAVEN DRIVE",
"city": "OSHKOSH",
"state": "WI",
"postal_code": "54904",
"telephone_number": "920-456-7100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOLLENHAUER",
"first_name": "LAURIE",
"name_prefix": "Dr.",
"credential": "P.T., D.P.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-09-10",
"last_updated": "2022-03-17",
"certification_date": "2022-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WI",
"license": "6490-24",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WI",
"license": "6490-024",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oshkosh, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.