NPIMap

Organization Active NPI

PT at Home, LLC

  • Physical Therapy Clinic/Center
  • Hales Corners, WI
National Provider Identifier
1912676065
Registry record updated Sep 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
PT AT HOME, LLC
Practice address
5584 S 115TH St
Hales Corners, WI 53130-1812
Phone
(414) 469-8728
NPI assigned
Sep 11, 2021
Last updated
Sep 11, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2021

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

Authorized official

Name
Lynette Gerke, P.T.NPI 1578536769
Title
Owner
Phone
(414) 469-8728

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X NU Primary

Addresses

Primary practice location

5584 S 115TH St
Hales Corners, WI 53130-1812

Mailing address

5584 S 115TH St
Hales Corners, WI 53130-1812
Phone (414) 469-8728

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1631318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631318400000",
    "number": "1912676065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5584 S 115TH ST",
            "city": "HALES CORNERS",
            "state": "WI",
            "postal_code": "531301812",
            "telephone_number": "414-469-8728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5584 S 115TH ST",
            "city": "HALES CORNERS",
            "state": "WI",
            "postal_code": "531301812",
            "telephone_number": "414-469-8728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PT AT HOME, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-11",
        "last_updated": "2021-09-11",
        "certification_date": "2021-09-11",
        "status": "A",
        "authorized_official_last_name": "GERKE",
        "authorized_official_first_name": "LYNETTE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "414-469-8728",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hales Corners, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2021; 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.