Mary Elys Lutkemeier

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1912 Issued in NE

Practice address

244 N Minden Ave
Minden, NE 68959-1643

Phone

(308) 832-3400

NPI assigned

Jun 2, 2008

Sex

Female

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 2, 2008.

{
    "created_epoch": "1212364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212364800000",
    "number": "1710146162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "244 N MINDEN AVE",
            "city": "MINDEN",
            "state": "NE",
            "postal_code": "689591643",
            "telephone_number": "308-832-3400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "244 N MINDEN AVE",
            "city": "MINDEN",
            "state": "NE",
            "postal_code": "689591643",
            "telephone_number": "308-832-3400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUTKEMEIER",
        "first_name": "MARY",
        "middle_name": "ELYS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-02",
        "last_updated": "2008-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NE",
            "license": "1912",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Minden, NE
• Physical Therapist in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2008; 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.