Active NPI
Kayla Lass
- Physical Therapist
- Green Bay, WI
National Provider Identifier
1316870926
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 17757-24
- Practice address
- 3263 Eaton Rd
Green Bay, WI 54311-6830 - Phone
- (920) 433-3500
- NPI assigned
- Jun 4, 2026
- Sex
- Unspecified or another gender identity
- 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 |
|---|---|---|---|---|
| Orthopedic Physical Therapist | 2251X0800X | |||
| Physical Therapist | 225100000X | 17757-24 | WI | Primary |
Addresses
Primary practice location
3263 Eaton Rd
Green Bay, WI 54311-6830
Mailing address
4517 Heffron St
Stevens Point, WI 54481-5578
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1780531200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1784764800000",
"number": "1316870926",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4517 HEFFRON ST",
"city": "STEVENS POINT",
"state": "WI",
"postal_code": "544815578"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3263 EATON RD",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "543116830",
"telephone_number": "920-433-3500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LASS",
"first_name": "KAYLA",
"sole_proprietor": "NO",
"sex": "X",
"enumeration_date": "2026-06-04",
"last_updated": "2026-07-23",
"certification_date": "2026-07-23",
"status": "A"
},
"taxonomies": [
{
"code": "2251X0800X",
"taxonomy_group": "",
"desc": "Physical Therapist, Orthopedic",
"state": null,
"license": null,
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WI",
"license": "17757-24",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Green Bay, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.