Individual provider Active NPI

Lisa Knauber, DPT

  • Physical Therapist
  • Amery, WI
National Provider Identifier
1740807403
Registry record updated Sep 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
15100-24 Issued in WI
Practice address
930 Elden Ave
Amery, WI 54001-1448
Phone
(715) 268-5103
Fax
(715) 268-5101
NPI assigned
Jun 29, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 15100-24 WI Primary

Addresses

Primary practice location

930 Elden Ave
Amery, WI 54001-1448

Mailing address

P.O. Box 147
Clear Lake, WI 54005-8905
Phone (715) 263-4103

Other practice location 1

1222 E Woodland Ave
Barron, WI 54812-1765
Phone (715) 537-3186

Other practice location 2

417 3rd Avenue
Clear Lake, WI 54005-8905
Phone (715) 263-4103

Other practice location 3

100 Becker St
Turtle Lake, WI 54889-9205
Phone (715) 986-4103

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
15100-24WIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Clear Lake Physical Therapy and Rehab Specialists LLC CurrentSince Sep 1, 2022 Accepting new patients
Mayo Clinic Health System-Northwest Wisconsin Region, Inc. Past Accepting new patients

Locations

930 Elden Ave
Amery, WI 54001
Phone (715) 268-5103

100 Becker St
Turtle Lake, WI 54889
Phone (715) 263-4103

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1593388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664236800000",
    "number": "1740807403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 147",
            "city": "CLEAR LAKE",
            "state": "WI",
            "postal_code": "540058905",
            "telephone_number": "715-263-4103",
            "fax_number": "715-263-4110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "930 ELDEN AVE",
            "city": "AMERY",
            "state": "WI",
            "postal_code": "540011448",
            "telephone_number": "715-268-5103",
            "fax_number": "715-268-5101"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1222 E Woodland Ave",
            "address_purpose": "LOCATION",
            "city": "Barron",
            "state": "WI",
            "postal_code": "548121765",
            "country_code": "US",
            "telephone_number": "715-537-3186",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "417 3rd Avenue",
            "address_purpose": "LOCATION",
            "city": "Clear Lake",
            "state": "WI",
            "postal_code": "540058905",
            "country_code": "US",
            "telephone_number": "715-263-4103",
            "fax_number": "715-263-4110",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 Becker St",
            "address_purpose": "LOCATION",
            "city": "Turtle Lake",
            "state": "WI",
            "postal_code": "548899205",
            "country_code": "US",
            "telephone_number": "715-986-4103",
            "fax_number": "715-986-4128",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KNAUBER",
        "first_name": "LISA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-29",
        "last_updated": "2022-09-27",
        "certification_date": "2022-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "15100-24",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Amery, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2022; 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.