Lori L Gulsrud-Neiber, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

070-008204 Issued in IL

Practice address

1686 Henry Luckow LN
Belvidere, IL 61008-1705

Phone

(815) 547-4777

Fax

(815) 547-1024

NPI assigned

Sep 14, 2006

Last updated

Jun 6, 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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Back in Action Holistic Health Center

  • Chiropractor
  • Rockford, IL
  • NPI 1063554343
  NPD (past)
• Northern Illinois Medical Group S. C.

  • Family Medicine Physician
  • Rockford, IL
  • NPI 1861670101
  NPD (past)

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370476800000",
    "number": "1902901879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1686 HENRY LUCKOW LN",
            "city": "BELVIDERE",
            "state": "IL",
            "postal_code": "610081705",
            "telephone_number": "815-547-4777",
            "fax_number": "815-547-1024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1686 HENRY LUCKOW LN",
            "city": "BELVIDERE",
            "state": "IL",
            "postal_code": "610081705",
            "telephone_number": "815-547-4777",
            "fax_number": "815-547-1024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GULSRUD-NEIBER",
        "first_name": "LORI",
        "middle_name": "L",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-14",
        "last_updated": "2013-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070-008204",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "K20025IL",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jyothi Gondi, M.D.
• Stephanie Ann Gorham II, MD
• Jody Gosnell, APN
• Elizabeth Gray, DNP
• Matthew W Greenwood, PT
• Alyssa Guse, LSW
• Mara Guse, PT, DPT
• Michael Anthony Hahndorf, DPT
• Claire Hallman, R.N.
• Mary J Harker, APN

• Physical Therapist in Belvidere, IL
• Providers in Belvidere, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2013; 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.