Active NPI
Lindsay A. Koepke, PT
- Physical Therapist
- Wausau, WI
National Provider Identifier
1881868305
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1228
- Practice address
- 720 S 6TH Ave
Wausau, WI 54401-5308 - Phone
- (715) 261-2650
- NPI assigned
- Apr 16, 2008
- 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 | 1228 | WI | Primary |
Addresses
Primary practice location
720 S 6TH Ave
Wausau, WI 54401-5308
Mailing address
720 S 6TH Ave
Wausau, WI 54401-5308
Phone (715) 261-2650
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 40106900 | Medicaid | WI | |
| 99171 | Other | WI | MARSHFIELD CLINIC PROV. |
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 |
|---|---|---|---|
| 1228 | WI | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1208304000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1208304000000",
"number": "1881868305",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "720 S 6TH AVE",
"city": "WAUSAU",
"state": "WI",
"postal_code": "544015308",
"telephone_number": "715-261-2650"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "720 S 6TH AVE",
"city": "WAUSAU",
"state": "WI",
"postal_code": "544015308",
"telephone_number": "715-261-2650"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOEPKE",
"first_name": "LINDSAY",
"middle_name": "A.",
"name_prefix": "Mrs.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-04-16",
"last_updated": "2008-04-16",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WI",
"license": "1228",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "40106900",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MARSHFIELD CLINIC PROV.",
"identifier": "99171",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wausau, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 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.