Active NPI
Lisa Conrad
- Physical Therapist
- Sheboygan, WI
National Provider Identifier
1881144657
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Practice address
- 2629 N 7TH St
Sheboygan, WI 53083-4932 - Phone
- (920) 451-7876
- NPI assigned
- Oct 5, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | WI | Primary |
Addresses
Primary practice location
2629 N 7TH St
Sheboygan, WI 53083-4932
Mailing address
120 Redtail Dr
Apt 12
Sheboygan Falls, WI 53085-3364
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100075360 | Medicaid | WI |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | lboettner117343@direct.myadvocateaurora.org | Direct | |
| FHIR URL | https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/ |
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1475625600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1711065600000",
"number": "1881144657",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "120 REDTAIL DR",
"address_2": "APT 12",
"city": "SHEBOYGAN FALLS",
"state": "WI",
"postal_code": "530853364"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2629 N 7TH ST",
"city": "SHEBOYGAN",
"state": "WI",
"postal_code": "530834932",
"telephone_number": "920-451-7876"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONRAD",
"first_name": "LISA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-10-05",
"last_updated": "2024-03-22",
"certification_date": "2024-03-22",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WI",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100075360",
"state": "WI"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "lboettner117343@direct.myadvocateaurora.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "2629 N 7th St",
"city": "Sheboygan",
"state": "WI",
"country_code": "US",
"postal_code": "530834932",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
"affiliation": "N",
"address_1": "2629 N 7th St",
"city": "Sheboygan",
"state": "WI",
"country_code": "US",
"postal_code": "530834932",
"country_name": "United States",
"address_type": "DOM"
}
],
"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 Mar 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.