Individual provider Active NPI

Lindsey Jean Bromberek

  • Physical Therapy Assistant
  • Oak Creek, WI
National Provider Identifier
1194967042
Registry record updated Mar 24, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
1571-19 Issued in WI
Practice address
8619 S Howell Ave
Oak Creek, WI 53154-2129
Phone
(414) 856-1888
Fax
(262) 364-2248
NPI assigned
Mar 24, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2009

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 1571-19 WI Primary

Addresses

Primary practice location

8619 S Howell Ave
Oak Creek, WI 53154-2129

Mailing address

8619 S Howell Ave
Oak Creek, WI 53154-2919
Phone (414) 856-1888

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
1571-19WIMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1237852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1237852800000",
    "number": "1194967042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8619 S HOWELL AVE",
            "city": "OAK CREEK",
            "state": "WI",
            "postal_code": "531542919",
            "telephone_number": "414-856-1888",
            "fax_number": "262-364-2248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8619 S HOWELL AVE",
            "city": "OAK CREEK",
            "state": "WI",
            "postal_code": "531542129",
            "telephone_number": "414-856-1888",
            "fax_number": "262-364-2248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROMBEREK",
        "first_name": "LINDSEY",
        "middle_name": "JEAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-24",
        "last_updated": "2009-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WI",
            "license": "1571-19",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Creek, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2009; 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.