Abby Lynn Risse, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

11323-024 Issued in WI

Practice address

402 1St St
Random Lake, WI 53075-1772

Phone

(920) 994-9700

Fax

(920) 994-4606

NPI assigned

Sep 23, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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.

• Easy Living Home Health Care Agency, Inc.

  dba Easy Living Therapy & Wellness

  • Occupational Therapist
  • Germantown, WI
  • NPI 1578882726

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1253664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1382400000000",
    "number": "1487988432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 1ST ST",
            "city": "RANDOM LAKE",
            "state": "WI",
            "postal_code": "530751772",
            "telephone_number": "920-994-9700",
            "fax_number": "920-994-4606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 1ST ST",
            "city": "RANDOM LAKE",
            "state": "WI",
            "postal_code": "530751772",
            "telephone_number": "920-994-9700",
            "fax_number": "920-994-4606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RISSE",
        "first_name": "ABBY",
        "middle_name": "LYNN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-23",
        "last_updated": "2013-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "11323-024",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NA APPLICATION PEND",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Prohealth Chiropractic Center S.C.
• Random Lake Dentistry, Inc
• Random Lake Fire Department
• Random Lake Medical Center LLC
• Random Lake Spine & Sports Clinic
• Marlena Elizabeth Salazar, PT
• Julie M. Schmitt, PT
• School District of Random Lake
• Sheboygan Senior Com
• Linda Stempel

• Physical Therapist in Random Lake, WI
• Providers in Random Lake, WI by specialty
• Physical Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 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.

Verify at the official NPI Registry.