Delora 'Lora' Halverson, LPTA; DOR

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

A1042 Issued in MN

Practice address

621 S 4TH St
Le Sueur, MN 56058-2203

Phone

(507) 665-8689

Fax

(507) 665-0072

NPI assigned

Jul 21, 2015

Last updated

Jul 21, 2015By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1437436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437436800000",
    "number": "1811372782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 S 4TH ST",
            "city": "LE SUEUR",
            "state": "MN",
            "postal_code": "560582203",
            "telephone_number": "507-665-8689",
            "fax_number": "507-665-0072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 S 4TH ST",
            "city": "LE SUEUR",
            "state": "MN",
            "postal_code": "560582203",
            "telephone_number": "507-665-8689",
            "fax_number": "507-665-0072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALVERSON",
        "first_name": "DELORA 'LORA'",
        "credential": "LPTA; DOR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-07-21",
        "last_updated": "2015-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MN",
            "license": "A1042",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tiffany Dawn Gordon, NP
• Ronald Julius Grothe, R. PH.
• H.Y.M. Inc. (Corner Drug of Le Sueur)
• Haemig Family Dentistry, PC (Haemig Family Dentistry)
• Timothy J Halloran, M.D.
• Rebecca Renee Hinderscheid, PSYD, LP
• Independent School District 2397
• Julie Johnson, LPN
• Asma Khalid Butler, MD
• Nicole Koukol

• Physical Therapy Assistant in Le Sueur, MN
• Providers in Le Sueur, MN by specialty
• Physical Therapy Assistant in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2015; 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.