Organization Active NPI

Jeanne H. Mather

Doing business as Northern Lights Therapy

  • Physical Therapist
  • Arbor Vitae, WI
National Provider Identifier
1770798274
Registry record updated Jul 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
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

Updated by the provider on Jul 1, 2008

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)CodeLicenseStatePrimary
Occupational Therapy AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 224Z00000X
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X Primary
Physical Therapy AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 225200000X
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 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

IdentifierTypeStateIssuer
41228400MedicaidWI

Other names 1

  • Northern Lights Therapy Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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": "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.

Verify at the official NPI Registry.