Active NPI
Mary Lynn Carle, P.T.
- Physical Therapist
- Madison, WI
National Provider Identifier
1376765370
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1813-024
- Practice address
- 6155 Mineral Point Rd
Madison, WI 53705-4457 - Phone
- (608) 230-4463
- Fax
- (608) 230-4368
- NPI assigned
- May 2, 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 Therapist | 225100000X | 1813-024 | WY | Primary |
Addresses
Primary practice location
6155 Mineral Point Rd
Madison, WI 53705-4457
Mailing address
417 Shepard Ter
Madison, WI 53705-3627
Phone (608) 238-3394
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 40066200 | 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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1813-024 | WY | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178064000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1376765370",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "417 SHEPARD TER",
"city": "MADISON",
"state": "WI",
"postal_code": "537053627",
"telephone_number": "608-238-3394"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6155 MINERAL POINT RD",
"city": "MADISON",
"state": "WI",
"postal_code": "537054457",
"telephone_number": "608-230-4463",
"fax_number": "608-230-4368"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARLE",
"first_name": "MARY",
"middle_name": "LYNN",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WY",
"license": "1813-024",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "40066200",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Madison, WI
Sources for this page
- 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.