Lynne Marie Breister, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

3988-24 Issued in WI

Practice address

11609 E Minnesuing Rd
Lake Nebagamon, WI 54849-9157

Phone

(715) 374-2021

Fax

(715) 374-2355

NPI assigned

Feb 6, 2008

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Lynne Johnson Former name

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1990

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1202256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567814400000",
    "number": "1699953208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11609 E MINNESUING RD",
            "city": "LAKE NEBAGAMON",
            "state": "WI",
            "postal_code": "548499157",
            "telephone_number": "715-374-2021",
            "fax_number": "715-374-2355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11609 E MINNESUING RD",
            "city": "LAKE NEBAGAMON",
            "state": "WI",
            "postal_code": "548499157",
            "telephone_number": "715-374-2021",
            "fax_number": "715-374-2355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREISTER",
        "first_name": "LYNNE",
        "middle_name": "MARIE",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-02-06",
        "last_updated": "2019-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "3988-24",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "4733",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LYNNE",
            "last_name": "JOHNSON",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Patrick Carey, RN
• Ethan E. Lawler, D.D.S., S.C.
• Zahid Hameed, MD
• Lisa Lynn Haugrud, LPN
• Karen C Krenzke, MD

• Physical Therapist in Lake Nebagamon, WI
• Providers in Lake Nebagamon, WI by specialty
• Physical Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.