Kimberly Ann Landsom, PT, ATC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

12596-24 Issued in WI

Practice address

6810 W State St
Wauwatosa, WI 53213-2807

Phone

(414) 259-0623

NPI assigned

Sep 4, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1252022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405987200000",
    "number": "1942533104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6810 W STATE ST",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532132807",
            "telephone_number": "414-259-0623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDSOM",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "credential": "PT, ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-04",
        "last_updated": "2014-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "12596-24",
            "primary": true
        },
        {
            "code": "2251S0007X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Sports",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly A Lamack, M.D.
• Alicia Faye Lambert, P.T.
• Timothy Lambrecht, MS, LPC-IT, CCMHC
• Kathryn Landgraf
• James H Landisch, MD
• Hannah Lang, CPM, LM
• Kirstin B Langhoff, RPH
• Emily C Langler, P.T.
• Jeffrey Langlois, CN, ND
• Diane Marie Lapota, P.T.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2014; 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.