Active NPI
Jeanne H. Mather
Doing business as Northern Lights Therapy
- Physical Therapist
- Arbor Vitae, WI
National Provider Identifier
1770798274
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Legal business name
- JEANNE H. MATHER
- Doing business as
- Northern Lights Therapy
- Practice address
- 1256 Brandy Lake Rd
Arbor Vitae, WI 54568-9218 - Phone
- (715) 356-9729
- Fax
- (715) 358-5209
- NPI assigned
- May 10, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Jeanne H Mather
- Title
- Owner
- Phone
- (715) 356-9729
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | |||
| Physical Therapist | 225100000X | Primary | ||
| Physical Therapy Assistant | 225200000X | |||
| Occupational Therapist | 225X00000X |
Addresses
Primary practice location
1256 Brandy Lake Rd
Arbor Vitae, WI 54568-9218
Mailing address
PO Box 827
1256 Brandy Lake Road
Arbor Vitae, WI 54568-0827
Phone (715) 356-9729
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 41228400 | Medicaid | WI |
Other names 1
- Northern Lights Therapy
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 3
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Occupational Therapist
- Arbor Vitae, WI
- NPI 1306046198
-
- Occupational Therapist
- Arbor Vitae, WI
- NPI 1023186848
-
- Occupational Therapy Assistant
- Arbor Vitae, WI
- NPI 1457429094
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178755200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1214870400000",
"number": "1770798274",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 827",
"address_2": "1256 BRANDY LAKE ROAD",
"city": "ARBOR VITAE",
"state": "WI",
"postal_code": "545680827",
"telephone_number": "715-356-9729",
"fax_number": "715-358-5209"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1256 BRANDY LAKE RD",
"city": "ARBOR VITAE",
"state": "WI",
"postal_code": "545689218",
"telephone_number": "715-356-9729",
"fax_number": "715-358-5209"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "JEANNE H. MATHER",
"organizational_subpart": "NO",
"enumeration_date": "2007-05-10",
"last_updated": "2008-07-01",
"status": "A",
"authorized_official_last_name": "MATHER",
"authorized_official_first_name": "JEANNE",
"authorized_official_middle_name": "H",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "715-356-9729"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Occupational Therapy Assistant",
"state": null,
"license": null,
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": true
},
{
"code": "225200000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physical Therapy Assistant",
"state": null,
"license": null,
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Occupational Therapist",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "41228400",
"state": "WI"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Northern Lights Therapy",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Arbor Vitae, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 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.