Linda Lee Roth-Dolens, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2965-024 Issued in WI

Practice address

10524 George Ave
Suite 2
Auburndale, WI 54412-0211

Phone

(715) 652-3470

Fax

(715) 652-3473

NPI assigned

Nov 16, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

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.

• Sport & Spine Clinic L P

  • Durable Medical Equipment & Medical Supplies
  • Wausau, WI
  • NPI 1134334691
  NPD (past)
• Sport & Spine Clinic LP

  • Physical Therapist
  • Auburndale, WI
  • NPI 1043252695
  NPD (past)

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295808046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 211",
            "address_2": "10524 GEORGE AVE, SUITE 2",
            "city": "AUBURNDALE",
            "state": "WI",
            "postal_code": "544120211",
            "telephone_number": "715-652-3470",
            "fax_number": "715-652-3473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10524 GEORGE AVE",
            "address_2": "SUITE 2",
            "city": "AUBURNDALE",
            "state": "WI",
            "postal_code": "544120211",
            "telephone_number": "715-652-3470",
            "fax_number": "715-652-3473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTH-DOLENS",
        "first_name": "LINDA",
        "middle_name": "LEE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "2965-024",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40286600",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Merrie Louise Degrand, PT
• Nicole Thiel Donnelly, PT
• Hart Equine Therapy Center, Inc.
• Michelle Leanne Hollatz, R.N.
• Mary L. Feltz
• Katherine Sabel
• Kimberly A Sievers
• Sport & Spine Clinic LP
• Carmen Maria Vazquez, RN, FNP

• Physical Therapist in Auburndale, WI
• Providers in Auburndale, WI by specialty
• Physical Therapist in Wisconsin

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

Verify at the official NPI Registry.