Active NPI
Sara A Ehlert, PHYSICAL THERAPIST
- Physical Therapist
- Green Bay, WI
National Provider Identifier
1881723302
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1776-24
- Practice address
- 1726 Shawano Ave
Green Bay, WI 54303-3216 - Phone
- (920) 496-4700
- NPI assigned
- Mar 2, 2007
- Last updated
- Jul 8, 2007
- 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 | 1776-24 | WI | Primary |
Addresses
Primary practice location
1726 Shawano Ave
Green Bay, WI 54303-3216
Mailing address
1726 Shawano Ave
Green Bay, WI 54303-3216
Phone (920) 496-4700
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 40312800 | Medicaid | WI |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1776-24 | WI | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172793600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1881723302",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1726 SHAWANO AVE",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "543033216",
"telephone_number": "920-496-4700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1726 SHAWANO AVE",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "543033216",
"telephone_number": "920-496-4700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EHLERT",
"first_name": "SARA",
"middle_name": "A",
"credential": "PHYSICAL THERAPIST",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WI",
"license": "1776-24",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "40312800",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Green Bay, WI
- Heidi Eggers-Ulve, D.D.S., M.S.
- Eggert & Eggert LLC (The Eyecare Place)
- Valarie T Eggleston, OTR
- Elia Dolores Eggum
- Brynn Emily Ehlers Jaschen, DO
- Jonathan Lee Eichelsdoerfer, MD
- Whitney Eichholz, D.D.S.
- Gail Marie Eichhorn
- Barbara A. Eland, C.R.N.A.
- Elbow Grease Massage Studio Inc (Elbow Grease Massage Studio)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.