NPIMap

Organization Active NPI

Southern Lakes Physical Therapy

  • Physical Therapy Clinic/Center
  • Milwaukee, WI
National Provider Identifier
1699965525
Registry record updated Oct 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
10406024 Issued in WI
Legal business name
SOUTHERN LAKES PHYSICAL THERAPY
Practice address
2121 S Kinnickinnic Ave
Suite Three
Milwaukee, WI 53207-1364
Phone
(414) 744-0707
NPI assigned
Jul 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2019

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

Authorized official

Name
Dr. William Lois, DPT
Title
Owner/President
Phone
(414) 744-0707

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X 10406024 WI Primary

Addresses

Primary practice location

2121 S Kinnickinnic Ave
Suite Three
Milwaukee, WI 53207-1364

Mailing address

2121 S Kinnickinnic Ave Ste 3
Milwaukee, WI 53207-1368
Phone (414) 744-0707

National Provider Directory

National Provider Directory

Locations

2121 S Kinnickinnic Ave
Ste 3
Milwaukee, WI 53207
Phone (414) 541-1118

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1185408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1570752000000",
    "number": "1699965525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2121 S KINNICKINNIC AVE STE 3",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532071368",
            "telephone_number": "414-744-0707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 S KINNICKINNIC AVE",
            "address_2": "SUITE THREE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532071364",
            "telephone_number": "414-744-0707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN LAKES PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-26",
        "last_updated": "2019-10-11",
        "status": "A",
        "authorized_official_last_name": "LOIS",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "414-744-0707",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "WI",
            "license": "10406024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2019; 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.