Individual provider Active NPI

Marissa Eirich, DPT

  • Physical Therapist
  • La Crosse, WI
National Provider Identifier
1497240287
Registry record updated Jun 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
14310 Issued in WI
Practice address
3501 Park Lane Dr
La Crosse, WI 54601-7747
Phone
(608) 519-9373
NPI assigned
Jun 25, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 14310 WI Primary

Addresses

Primary practice location

3501 Park Lane Dr
La Crosse, WI 54601-7747

Mailing address

106 S Holmen Dr Ste 2
Holmen, WI 54636-9468
Phone (608) 526-9888

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

LicenseStateTypeSpecialty
14310WIMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1529884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529884800000",
    "number": "1497240287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 S HOLMEN DR STE 2",
            "city": "HOLMEN",
            "state": "WI",
            "postal_code": "546369468",
            "telephone_number": "608-526-9888",
            "fax_number": "608-526-9965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3501 PARK LANE DR",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546017747",
            "telephone_number": "608-519-9373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EIRICH",
        "first_name": "MARISSA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-25",
        "last_updated": "2018-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "14310",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Crosse, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2018; 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.