Individual provider Active NPI

Sara Lynn Kenne, LPTA

  • Physical Therapy Assistant
  • Sheboygan, WI
National Provider Identifier
1811228158
Registry record updated Jan 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
1642-019 Issued in WI
Practice address
1902 Mead Ave.
Sheboygan, WI 53081
Phone
(920) 458-8333
Fax
(920) 458-6837
NPI assigned
Jan 27, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 1642-019 WI Primary

Addresses

Primary practice location

1902 Mead Ave.
Sheboygan, WI 53081

Mailing address

9301 N 76TH St
Milwaukee, WI 53223-1074
Phone (414) 357-5105

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1642-019WIMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1264550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357430400000",
    "number": "1811228158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9301 N 76TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532231074",
            "telephone_number": "414-357-5105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1902 MEAD AVE.",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "53081",
            "telephone_number": "920-458-8333",
            "fax_number": "920-458-6837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNE",
        "first_name": "SARA",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "LPTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-27",
        "last_updated": "2013-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WI",
            "license": "1642-019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sheboygan, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2013; 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.