Individual provider Active NPI

Lori L. Webster-Dahl, P.T.

  • Physical Therapist
  • Mauston, WI
National Provider Identifier
1922150465
Registry record updated Apr 7, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
4953-024 Issued in WI
Practice address
610 McEvoy St
Mauston, WI 53948-1438
Phone
(608) 548-5215
NPI assigned
Jan 17, 2007
Last updated
Apr 7, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 4953-024 WI Primary

Addresses

Primary practice location

610 McEvoy St
Mauston, WI 53948-1438

Mailing address

N8560 8TH Ave
New Lisbon, WI 53950-9185
Phone (608) 548-5212

Other identifiers 1

IdentifierTypeStateIssuer
40457700MedicaidWI

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

LicenseStateTypeSpecialty
4953-024WIMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1239062400000",
    "number": "1922150465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N8560 8TH AVE",
            "city": "NEW LISBON",
            "state": "WI",
            "postal_code": "539509185",
            "telephone_number": "608-548-5212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 MCEVOY ST",
            "city": "MAUSTON",
            "state": "WI",
            "postal_code": "539481438",
            "telephone_number": "608-548-5215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEBSTER-DAHL",
        "first_name": "LORI",
        "middle_name": "L.",
        "name_prefix": "Ms.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-17",
        "last_updated": "2009-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "4953-024",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40457700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mauston, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2009; 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.