Active NPI
William H. Letsom, PT
- Physical Therapist
- Kenosha, WI
National Provider Identifier
1356330609
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1882-024
- Practice address
- 7201 Green Bay Rd
Kenosha, WI 53142-3522 - Phone
- (262) 694-3977
- Fax
- (262) 694-5648
- NPI assigned
- Oct 19, 2005
- Sex
- Male
- Sole proprietor
- Yes
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 Therapist | 225100000X | 1882-024 | WI | Primary |
Addresses
Primary practice location
7201 Green Bay Rd
Kenosha, WI 53142-3522
Mailing address
7201 Green Bay Rd
Kenosha, WI 53142-3522
Phone (262) 694-3977
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 41811000 | Medicaid | WI | |
| 40189600 | 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 |
|---|---|---|---|
| 1882-024 | WI | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1129680000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1373241600000",
"number": "1356330609",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7201 GREEN BAY RD",
"city": "KENOSHA",
"state": "WI",
"postal_code": "531423522",
"telephone_number": "262-694-3977",
"fax_number": "262-694-5648"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7201 GREEN BAY RD",
"city": "KENOSHA",
"state": "WI",
"postal_code": "531423522",
"telephone_number": "262-694-3977",
"fax_number": "262-694-5648"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LETSOM",
"first_name": "WILLIAM",
"middle_name": "H.",
"name_prefix": "Mr.",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-10-19",
"last_updated": "2013-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WI",
"license": "1882-024",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "41811000",
"state": "WI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "40189600",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Kenosha, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.