Individual provider Active NPI

Jessica Lambrecht, PTA

  • Physical Therapy Assistant
  • Manitowoc, WI
National Provider Identifier
1881240018
Registry record updated Aug 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
2963-19 Issued in WI
Practice address
1445 N 7TH St
Manitowoc, WI 54220-2011
Phone
(920) 682-0314
NPI assigned
Aug 13, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2019

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 2963-19 WI Primary

Addresses

Primary practice location

1445 N 7TH St
Manitowoc, WI 54220-2011

Mailing address

1505 Argonne Dr
Green Bay, WI 54304-2905
Phone (920) 604-3174

Other names 1

  • Jessica Raasch Former name

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
2963-19WIMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1565654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565654400000",
    "number": "1881240018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1505 ARGONNE DR",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543042905",
            "telephone_number": "920-604-3174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1445 N 7TH ST",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542202011",
            "telephone_number": "920-682-0314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAMBRECHT",
        "first_name": "JESSICA",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-13",
        "last_updated": "2019-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WI",
            "license": "2963-19",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "RAASCH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Manitowoc, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2019; 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.