Individual provider Active NPI

Lori Ann Serra, PTA

  • Physical Therapy Assistant
  • Wauwatosa, WI
National Provider Identifier
1841457538
Registry record updated May 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
42019 Issued in WI
Practice address
201 N Mayfair Rd
Wauwatosa, WI 53226-4216
Phone
(414) 259-7275
Fax
(414) 259-7515
NPI assigned
May 20, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2008

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 42019 WI Primary

Addresses

Primary practice location

201 N Mayfair Rd
Wauwatosa, WI 53226-4216

Mailing address

201 N Mayfair Rd
Wauwatosa, WI 53226-4216
Phone (414) 259-7275

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
42019WIMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1211241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211241600000",
    "number": "1841457538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 N MAYFAIR RD",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532264216",
            "telephone_number": "414-259-7275",
            "fax_number": "414-259-7515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 N MAYFAIR RD",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532264216",
            "telephone_number": "414-259-7275",
            "fax_number": "414-259-7515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERRA",
        "first_name": "LORI",
        "middle_name": "ANN",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-20",
        "last_updated": "2008-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WI",
            "license": "42019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wauwatosa, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 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.