Active NPI
Karin Lynn Buckholdt, PT
- Physical Therapist
- Elm Grove, WI
National Provider Identifier
1669615019
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 5132-024
- Practice address
- 13105 Watertown Plank Rd
Elm Grove, WI 53122-2213 - Phone
- (262) 787-1375
- Fax
- (262) 796-1528
- NPI assigned
- Apr 15, 2009
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 5132-024 | WI | Primary |
Addresses
Primary practice location
13105 Watertown Plank Rd
Elm Grove, WI 53122-2213
Mailing address
13105 Watertown Plank Rd
Elm Grove, WI 53122-2213
Phone (262) 787-1375
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 |
|---|---|---|---|
| 5132-024 | WI | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1239753600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1239753600000",
"number": "1669615019",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13105 WATERTOWN PLANK RD",
"city": "ELM GROVE",
"state": "WI",
"postal_code": "531222213",
"telephone_number": "262-787-1375",
"fax_number": "262-796-1528"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13105 WATERTOWN PLANK RD",
"city": "ELM GROVE",
"state": "WI",
"postal_code": "531222213",
"telephone_number": "262-787-1375",
"fax_number": "262-796-1528"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUCKHOLDT",
"first_name": "KARIN",
"middle_name": "LYNN",
"name_prefix": "Mrs.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-04-15",
"last_updated": "2009-04-15",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WI",
"license": "5132-024",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Elm Grove, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.