Individual provider Active NPI

Luann S Herkstroeter, P.T.

  • Physical Therapist
  • Laramie, WY
National Provider Identifier
1619963014
Registry record updated Nov 2, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
362 Issued in WY
Practice address
1575 N 4TH St
Suite 101
Laramie, WY 82072-2091
Phone
(307) 745-5434
Fax
(307) 745-5484
NPI assigned
Sep 21, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2007

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 362 WY Primary

Addresses

Primary practice location

1575 N 4TH St
Suite 101
Laramie, WY 82072-2091

Mailing address

PO Box 1146
Laramie, WY 82073-1146
Phone (307) 745-5434

Other identifiers 2

IdentifierTypeStateIssuer
312638OtherWYBLUE CROSS BLUE SHIELD
P00199469OtherWYRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040416000804 WY Practitioner - Physical Therapist in Private Practice 6901890706 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
362WYMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Homestead Physical Therapy PC CurrentSince Jan 13, 2004 Accepting new patients

Locations

1575 N 4th St
Ste 101
Laramie, WY 82072
Phone (307) 745-5434

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1127260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193961600000",
    "number": "1619963014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1146",
            "city": "LARAMIE",
            "state": "WY",
            "postal_code": "820731146",
            "telephone_number": "307-745-5434",
            "fax_number": "307-745-5484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1575 N 4TH ST",
            "address_2": "SUITE 101",
            "city": "LARAMIE",
            "state": "WY",
            "postal_code": "820722091",
            "telephone_number": "307-745-5434",
            "fax_number": "307-745-5484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERKSTROETER",
        "first_name": "LUANN",
        "middle_name": "S",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-21",
        "last_updated": "2007-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WY",
            "license": "362",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "312638",
            "state": "WY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00199469",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Laramie, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.