Individual provider Active NPI

Brooklyn Marie Laube, DPT

  • Physical Therapist
  • Altoona, WI
National Provider Identifier
1659757987
Registry record updated Dec 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
13128-24 Issued in WI
Practice address
1200 Oakleaf Way
Suite B
Altoona, WI 54720-2245
Phone
(715) 839-9266
NPI assigned
Aug 10, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2021

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 13128-24 WI Primary

Addresses

Primary practice location

1200 Oakleaf Way
Suite B
Altoona, WI 54720-2245

Mailing address

1200 Oakleaf Way
Suite B
Altoona, WI 54720-2245
Phone (715) 839-9266

Other identifiers 1

IdentifierTypeStateIssuer
13158OtherWIPHYSICAL THERAPY LICENSE

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
13128-24WIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Northwoods Sport & Hand, Inc Physical Therapist CurrentSince Aug 5, 2015 Accepting new patients
Northwoods Sport & Hand, Inc CurrentSince Aug 5, 2015 Accepting new patients

Locations

1200 Oakleaf Way
Ste B
Altoona, WI 54720
Phone (715) 839-9266

757 Lakeland Dr
Ste A
Chippewa Fls, WI 54729
Phone (715) 723-5060

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1439164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638316800000",
    "number": "1659757987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 OAKLEAF WAY",
            "address_2": "SUITE B",
            "city": "ALTOONA",
            "state": "WI",
            "postal_code": "547202245",
            "telephone_number": "715-839-9266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 OAKLEAF WAY",
            "address_2": "SUITE B",
            "city": "ALTOONA",
            "state": "WI",
            "postal_code": "547202245",
            "telephone_number": "715-839-9266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAUBE",
        "first_name": "BROOKLYN",
        "middle_name": "MARIE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-10",
        "last_updated": "2021-12-01",
        "certification_date": "2021-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "13128-24",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICAL THERAPY LICENSE",
            "identifier": "13158",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Altoona, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2021; 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.