Active NPI
Sally Lynn Bohlmann, PTA
- Physical Therapy Assistant
- Cedarburg, WI
National Provider Identifier
1265645972
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 57-019
- Practice address
- N27W5707 Lincoln Blvd
Cedar Springs Health and Rehab Center
Cedarburg, WI 53012-2852 - Phone
- (262) 376-7676
- NPI assigned
- May 8, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 57-019 | WI | Primary |
Addresses
Primary practice location
N27W5707 Lincoln Blvd
Cedar Springs Health and Rehab Center
Cedarburg, WI 53012-2852
Mailing address
8618 N 53Rd St
Brown Deer, WI 53223-3010
Phone (414) 531-0253
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 40190100 | Medicaid | WI |
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 |
|---|---|---|---|
| 57-019 | WI | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178582400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1265645972",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8618 N 53RD ST",
"city": "BROWN DEER",
"state": "WI",
"postal_code": "532233010",
"telephone_number": "414-531-0253"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "N27W5707 LINCOLN BLVD",
"address_2": "CEDAR SPRINGS HEALTH AND REHAB CENTER",
"city": "CEDARBURG",
"state": "WI",
"postal_code": "530122852",
"telephone_number": "262-376-7676"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOHLMANN",
"first_name": "SALLY",
"middle_name": "LYNN",
"name_prefix": "Mrs.",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-08",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "WI",
"license": "57-019",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "40190100",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cedarburg, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.