Mandy Mickelson, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

1409-019 Issued in WI

Practice address

2501 Shelby Rd
La Crosse, WI 54601-8037

Phone

(608) 788-5700

NPI assigned

May 14, 2008

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1210723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210723200000",
    "number": "1659548063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6232 STATE HIGHWAY 16",
            "city": "SPARTA",
            "state": "WI",
            "postal_code": "546563505",
            "telephone_number": "608-343-1236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 SHELBY RD",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546018037",
            "telephone_number": "608-788-5700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICKELSON",
        "first_name": "MANDY",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-14",
        "last_updated": "2008-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WI",
            "license": "1409-019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel L Meyer, PA-C
• Mary Elizabeth Meyers
• Michael S Meyers, MD
• Mickenzie Meyers
• MH Imaging - la Crosse
• Elizabeth Larson Middleton, PA
• Mark Alan Midthun, M.D.
• Midwest Chiropractic Associates, S.C.
• Polly A Mihalovic, RD
• Amanda Agnes Milanowski

• Physical Therapy Assistant in La Crosse, WI
• Providers in La Crosse, WI by specialty
• Physical Therapy Assistant in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2008; 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.