Active NPI
Lawrence Michael Hudson, PT
- Physical Therapist
- Pleasant Prairie, WI
National Provider Identifier
1912407776
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 17659-24
- Practice address
- 9809 39TH Ave Ste 2
Pleasant Prairie, WI 53158-3733 - Phone
- (262) 925-5080
- NPI assigned
- Feb 19, 2018
- Last updated
- Sep 16, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 5501010980 | MI | |
| Physical Therapist | 225100000X | 17659-24 | WI | Primary |
Addresses
Primary practice location
9809 39TH Ave Ste 2
Pleasant Prairie, WI 53158-3733
Mailing address
197 State St
Boyne City, MI 49712-1288
Phone (231) 582-6365
Other practice location 1
10222 74th St Ste 211
Kenosha, WI 53142-6810
Phone (262) 925-5020
Other practice location 2
197 State St
Boyne City, MI 49712-1288
Phone (231) 582-6365
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
| License | State | Type | Specialty |
|---|---|---|---|
| 5501010980 | MI | MD | Physical Therapist |
| 103708-875 | WI | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Munson Healthcare Charlevoix Hospital | Past | Accepting new patients | |
| Munson Healthcare Charlevoix Hospital | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Medicare Defined Swing Bed Hospital Unit
- Charlevoix, MI
- NPI 1164508891
-
dba Munson Healthcare Charlevoix Walk-In Clinic
- Family Medicine Physician
- Charlevoix, MI
- NPI 1972367043
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1518998400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1789516800000",
"number": "1912407776",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "197 STATE ST",
"city": "BOYNE CITY",
"state": "MI",
"postal_code": "497121288",
"telephone_number": "231-582-6365",
"fax_number": "231-582-3738"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9809 39TH AVE STE 2",
"city": "PLEASANT PRAIRIE",
"state": "WI",
"postal_code": "531583733",
"telephone_number": "262-925-5080"
}
],
"practiceLocations": [
{
"address_1": "10222 74th St Ste 211",
"address_purpose": "LOCATION",
"city": "Kenosha",
"state": "WI",
"postal_code": "531426810",
"country_code": "US",
"telephone_number": "262-925-5020",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "197 State St",
"address_purpose": "LOCATION",
"city": "Boyne City",
"state": "MI",
"postal_code": "497121288",
"country_code": "US",
"telephone_number": "231-582-6365",
"fax_number": "231-582-3738",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HUDSON",
"first_name": "LAWRENCE",
"middle_name": "MICHAEL",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-02-19",
"last_updated": "2026-09-16",
"certification_date": "2026-09-16",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MI",
"license": "5501010980",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WI",
"license": "17659-24",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Pleasant Prairie, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.