Elizabeth R Bouressa, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

1588-019 Issued in WI

Practice address

2915 N Meade St
Appleton, WI 54911-1509

Phone

(920) 993-6837

NPI assigned

Nov 11, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• RG-Rhinelander, Inc.

  • Skilled Nursing Facility
  • Rhinelander, WI
  • NPI 1407164312
  NPD (past)

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

{
    "created_epoch": "1257897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728345600000",
    "number": "1245567239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2915 N MEADE ST",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549111509",
            "telephone_number": "920-993-6837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2915 N MEADE ST",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549111509",
            "telephone_number": "920-993-6837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOURESSA",
        "first_name": "ELIZABETH",
        "middle_name": "R",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-11",
        "last_updated": "2024-10-08",
        "certification_date": "2024-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WI",
            "license": "1588-019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bortscreation LLC
• Alice M Boshoven, MD
• Jean M Bouche, R.D.
• Michelle Bouche
• Mona S Boulos, MD
• Lucy Bouressa
• Eric R Bowen, APNP
• Boyson Chiropractic LLC
• Chris W Boyson, D.C.
• Craig G Boyson, DC

• Physical Therapy Assistant in Appleton, WI
• Providers in Appleton, WI by specialty
• Physical Therapy Assistant in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2024; 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.