Lace Elly Luedke, PT PHD DPT OCS CSCS

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5847024 Issued in WI

Practice address

1901 E Capitol Dr
Appleton, WI 54911-8488

Phone

(920) 931-2532

NPI assigned

May 3, 2006

Last updated

Jul 21, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Radiology Associates of the Fox Valley, SC

  • Diagnostic Radiology Physician
  • Neenah, WI
  • NPI 1477539443
  NPD (past)
• New Beginnings Physical Therapy Inc.

  • Orthopedic Physical Therapist
  • Fishersville, VA
  • NPI 1306916226
  NPD (past)
• Walker Therapy Clinic, Inc

  • Specialist
  • Cabot, AR
  • NPI 1972634210

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1447218730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 ALGOMA BLVD",
            "address_2": "UW-OSHKOSH, 108B ALBEE HALL",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "54901",
            "telephone_number": "920-424-0891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 E CAPITOL DR",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549118488",
            "telephone_number": "920-931-2532"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2200 S Kensington Dr",
            "address_purpose": "LOCATION",
            "city": "Appleton",
            "state": "WI",
            "postal_code": "549154144",
            "country_code": "US",
            "telephone_number": "920-738-0200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUEDKE",
        "first_name": "LACE",
        "middle_name": "ELLY",
        "name_prefix": "Dr.",
        "credential": "PT PHD DPT OCS CSCS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-03",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "5847024",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AR",
            "license": "2611",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NSCA CSCS",
            "identifier": "977732",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCKENZIE INSTITUTE CERT",
            "identifier": "1305",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ryan Lubbe
• Adam Edward Luboff, PHARMACIST
• Mary A Luck, PTA
• Kendall Luckeroth, OTR/L
• Christopher William Ludden
• Nicole Katherine Luehring, FNP
• Benjamin J Luitjens, PA-C
• Boyd C Lumsden, M.D.
• Laura M Lundgren, PA C
• Kristin K Lundine, APNP

• Physical Therapist in Appleton, WI
• Providers in Appleton, 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 21, 2022; 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.