Individual provider Active NPI

Lindsay M Nelson, DPT

  • Physical Therapist
  • Green Bay, WI
National Provider Identifier
1942736020
Registry record updated Oct 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
15216-24 Issued in WI
Practice address
744 S Webster Ave
Green Bay, WI 54301-3505
Phone
(920) 433-7822
Fax
(920) 433-3651
NPI assigned
May 10, 2017
Last updated
Oct 2, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT016075 OH
Physical Therapist 225100000X 15216-24 WI Primary

Addresses

Primary practice location

744 S Webster Ave
Green Bay, WI 54301-3505

Mailing address

PO Box 22487
Green Bay, WI 54305-2487
Phone (920) 445-7222

Other practice location 1

1980 Lynn Dr
Orrville, OH 44667-2337
Phone (330) 683-4075

Other names 1

  • Lindsay M Moore Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201013000889 WI Practitioner - Physical Therapist in Private Practice 6507286580 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT016075OHMDPhysical Therapist
15216-24WIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Bellin Memorial Hospital Inc Physical Therapist CurrentSince Oct 2, 2020 Accepting new patients
Oconto Hospital & Medical Center Inc CurrentSince Feb 19, 2021 Accepting new patients
Oconto Hospital & Medical Center Inc Physical Therapist CurrentSince Feb 19, 2021 Accepting new patients
Oconto Hospital & Medical Center Inc Current Accepting new patients
Bellin Memorial Hospital Inc Current Accepting new patients
Bellin Memorial Hospital Inc CurrentSince Oct 2, 2020 Accepting new patients

Locations

1920 Libal St
Green Bay, WI 54301
Phone (920) 432-5434

744 S Webster Ave
Green Bay, WI 54301
Phone (920) 433-6025

744 S Webster Ave
Fl 7
Green Bay, WI 54301

2820 Roosevelt Rd
Marinette, WI 54143
Phone (715) 330-6171

820 Arbutus Ave
Oconto, WI 54153
Phone (920) 835-1100

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1494374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601596800000",
    "number": "1942736020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22487",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543052487",
            "telephone_number": "920-445-7222",
            "fax_number": "920-445-7289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "744 S WEBSTER AVE",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543013505",
            "telephone_number": "920-433-7822",
            "fax_number": "920-433-3651"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1980 Lynn Dr",
            "address_purpose": "LOCATION",
            "city": "Orrville",
            "state": "OH",
            "postal_code": "446672337",
            "country_code": "US",
            "telephone_number": "330-683-4075",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NELSON",
        "first_name": "LINDSAY",
        "middle_name": "M",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-10",
        "last_updated": "2020-10-02",
        "certification_date": "2020-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "PT016075",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "15216-24",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LINDSAY",
            "last_name": "MOORE",
            "middle_name": "M",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Green Bay, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.