Individual provider Active NPI

Lynn Winter

  • Physical Therapy Assistant
  • South Milwaukee, WI
National Provider Identifier
1407077506
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
616019 Issued in WI
Practice address
3821 S Chicago Ave
South Milwaukee, WI 53172-3712
Phone
(414) 762-6379
NPI assigned
May 2, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 616019 WI Primary

Addresses

Primary practice location

3821 S Chicago Ave
South Milwaukee, WI 53172-3712

Mailing address

9068 S River Edge Dr
Oak Creek, WI 53154-3734
Phone (414) 762-6379

Other identifiers 2

IdentifierTypeStateIssuer
40094000MedicaidWI
616 019OtherWILIC #

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

LicenseStateTypeSpecialty
616019WIMDPhysical Therapy Assistant

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": "1183939200000",
    "number": "1407077506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9068 S RIVER EDGE DR",
            "city": "OAK CREEK",
            "state": "WI",
            "postal_code": "531543734",
            "telephone_number": "414-762-6379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3821 S CHICAGO AVE",
            "city": "SOUTH MILWAUKEE",
            "state": "WI",
            "postal_code": "531723712",
            "telephone_number": "414-762-6379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINTER",
        "first_name": "LYNN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-02",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WI",
            "license": "616019",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40094000",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LIC #",
            "identifier": "616 019",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Milwaukee, 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.

Verify at the official NPI Registry.