Active NPI
Zachariah Mumm, CTRS
- Recreation Therapist
- La Crosse, WI
National Provider Identifier
1629953401
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Recreation Therapist
- License
- 85879
- Practice address
- 1815 Avon St
La Crosse, WI 54603-2139 - Phone
- (608) 317-3959
- NPI assigned
- Aug 9, 2025
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Recreation Therapist | 225800000X | 85879 | WI | Primary |
Addresses
Primary practice location
1815 Avon St
La Crosse, WI 54603-2139
Mailing address
1815 Avon St
La Crosse, WI 54603-2139
Phone (608) 317-3959
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
| License | State | Type | Specialty |
|---|---|---|---|
| 85879 | WI | MD | Diagnostic Radiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1754697600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1754697600000",
"number": "1629953401",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1815 AVON ST",
"city": "LA CROSSE",
"state": "WI",
"postal_code": "546032139",
"telephone_number": "608-317-3959"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1815 AVON ST",
"city": "LA CROSSE",
"state": "WI",
"postal_code": "546032139",
"telephone_number": "608-317-3959"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MUMM",
"first_name": "ZACHARIAH",
"credential": "CTRS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2025-08-09",
"last_updated": "2025-08-09",
"certification_date": "2025-08-09",
"status": "A"
},
"taxonomies": [
{
"code": "225800000X",
"taxonomy_group": "",
"desc": "Recreation Therapist",
"state": "WI",
"license": "85879",
"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 Aug 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.