Active NPI
Lynn Marie Selle, P.T.
- Physical Therapist
- Saint Croix Falls, WI
National Provider Identifier
1669789624
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1584-24
- Practice address
- 750 E Louisiana St
Saint Croix Falls, WI 54024-9501 - Phone
- (715) 483-9815
- NPI assigned
- Sep 10, 2010
- 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 | 1584-24 | WI | Primary |
Addresses
Primary practice location
750 E Louisiana St
Saint Croix Falls, WI 54024-9501
Mailing address
2900 Charlevoix Dr SE Ste 200
Grand Rapids, MI 49546-7086
Phone (800) 684-8048
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 |
|---|---|---|---|
| 1584-24 | WI | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1284076800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1284076800000",
"number": "1669789624",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2900 CHARLEVOIX DR SE STE 200",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495467086",
"telephone_number": "800-684-8048"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "750 E LOUISIANA ST",
"city": "SAINT CROIX FALLS",
"state": "WI",
"postal_code": "540249501",
"telephone_number": "715-483-9815"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SELLE",
"first_name": "LYNN",
"middle_name": "MARIE",
"name_prefix": "Ms.",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-09-10",
"last_updated": "2010-09-10",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WI",
"license": "1584-24",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Croix Falls, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.