Kerry L. Lahti, MPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

9809-024 Issued in WI

Practice address

9675 E Elm Rd
Poplar, WI 54864-9102

Phone

(715) 364-8565

Fax

(715) 364-8574

NPI assigned

Aug 7, 2006

Last updated

Jun 26, 2013By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 6

Other names 1

• Kerry L. Marquardt Former name

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• The Lakes Community Health Center, Inc

  dba NorthLakes Community Clinic

  • Federally Qualified Health Center (FQHC)
  • Iron River, WI
  • NPI 1811178825
  Medicare reassignment NPD
• The Lakes Community Health Center, Inc

  dba NorthLakes Community Clinic

  • Federally Qualified Health Center (FQHC)
  • White Lake, WI
  • NPI 1679983423
  NPD

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

{
    "created_epoch": "1154908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372204800000",
    "number": "1902815848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 N PROVIDENCE AVE",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549138018",
            "telephone_number": "920-257-2005",
            "fax_number": "920-257-2004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9675 E ELM RD",
            "city": "POPLAR",
            "state": "WI",
            "postal_code": "548649102",
            "telephone_number": "715-364-8565",
            "fax_number": "715-364-8574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAHTI",
        "first_name": "KERRY",
        "middle_name": "L.",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-07",
        "last_updated": "2013-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "9809-024",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00210715",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP HEALTH/BCBS OF MN",
            "identifier": "382K3LA",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40455700",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA-POPLAR",
            "identifier": "64-05466",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA-ASHLAND",
            "identifier": "64-05467",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SECURITY HEALTH PLAN",
            "identifier": "111196",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KERRY",
            "last_name": "MARQUARDT",
            "middle_name": "L.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Eve Bagan, REGISTERED NURSE
• Jessica Lynn Beckman, M.A., CCC-SLP
• Breathe Chiropractic LLC
• Kyle Johnson, DPT
• Amy M. Kline, PTA
• Cindy L Nelson, BS
• Northwoods Family Chiropractic
• Orthopedic & Spine Therapy of Poplar, SC
• Orthopedic & Spine Therapy of Poplar, SC
• The Lakes Community Health Center, Inc (The Lakes Community Health Center)

• Physical Therapist in Poplar, WI
• Providers in Poplar, WI by specialty
• Physical Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.