LYDEL MARIE GERONDALE (NPI# 1538668405) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538668405 |
| Entity Type | Individual |
| Full Name | LYDEL MARIE GERONDALE |
| Credential | PTA |
| Practice Address |
2305 San Luis Pl Green Bay WI 54304-5211 |
| Mailing Address |
1112 Roland Ln Apt 16 Green Bay WI 54303-6394 |
| Practice Telephone | 9204945231 |
| Mailing Telephone | 9206040631 |
| Enumeration Date | 2018-02-06 |
| Last Update Date | 2018-02-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225200000X | Physical Therapy Assistant | 2504-19 | WI | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
2305 SAN LUIS PL |
| City | GREEN BAY |
| State | WI |
| Zip Code | 54304-5211 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588839492 | San Luis Medical & Rehab Center | Skilled Nursing Facility | 2305 San Luis Pl, Green Bay, WI 54304-5211 | 2008-04-23 |
| 1881124246 | Linda Burrows | Physical Therapy Assistant | 2305 San Luis Pl, Green Bay, WI 54304-5211 | 2017-06-18 |
| 1639605363 | The Bay At Maple Ridge Health and Rehabilitation LLC | Skilled Nursing Facility | 2305 San Luis Pl, Green Bay, WI 54304 | 2017-05-01 |
| 1912446618 | Chelsea Vande Hei | Speech-Language Pathologist | 2305 San Luis Pl, Green Bay, WI 54304-5211 | 2017-02-15 |
| 1750748364 | Lauren Vermillion | Physical Therapist | 2305 San Luis Pl, Green Bay, WI 54304-5211 | 2016-01-27 |
| 1346629490 | Sarah Wenzlaff | Occupational Therapy Assistant | 2305 San Luis Pl, Green Bay, WI 54304-5211 | 2015-05-21 |
| 1588080055 | San Luis Health Care LLC | Skilled Nursing Facility | 2305 San Luis Pl, Green Bay, WI 54304-5211 | 2014-03-08 |
| 1316389786 | Susan M Coyle | Occupational Therapy Assistant | 2305 San Luis Pl, Green Bay, WI 54304-5211 | 2013-07-25 |
| 1386916476 | Sara Marie Radke | Physical Therapy Assistant | 2305 San Luis Pl, Green Bay, WI 54304-5211 | 2012-02-03 |
| 1003193236 | Stephanie Keranen | Occupational Therapy Assistant | 2305 San Luis Pl, Green Bay, WI 54304-5211 | 2011-11-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689196255 | Kristen Ashley Haltom | Registered Nurse | 2979 Allied St Suite C, Green Bay, WI 54304 | 2017-07-14 |
| 1649671421 | Heather Marie Novak | Counselor | 2979 Allied St Unit C, Green Bay, WI 54304 | 2014-09-11 |
| 1356777684 | Nathan Weir | Specialist/Technologist | 1265 Lombardi Avenue, Green Bay, WI 54304 | 2013-09-18 |
| 1922349927 | John W Hartman | Internal Medicine | 916 Willard Dr, Suite 200, Green Bay, WI 54304 | 2013-03-15 |
| 1447551379 | Citralina M Haruo | Community Health Worker | 1110 11th Avenue, Green Bay, WI 54304 | 2010-11-09 |
| 1497061352 | Daniel James Gustin | Pharmacist | 1109 Lombardi Ave, Green Bay, WI 54304 | 2010-08-28 |
| 1316259898 | Karen A Detrick | Occupational Therapy Assistant | 1040 Pilgram Way, Woodside Senior Communities, Green Bay, WI 54304 | 2010-07-13 |
| 1861667362 | Planned Parenthood of Wi, Inc | Non-Pharmacy Dispensing Site | 2605 S. Oneida St. Suite 107, Green Bay, WI 54304 | 2008-04-25 |
| 1891967303 | Kimberley M Welk | Marriage & Family Therapist | 926 Willard Dr Ste 136, Green Bay, WI 54304 | 2008-03-25 |
| 1750563698 | Richard Lawrence Beyer | Hearing Instrument Specialist | 2154 S Ridge Rd, Green Bay, WI 54304 | 2007-12-03 |
| Find all providers in zip 54304 | ||||
| Taxonomy Code | 225200000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapy Assistant |
| (1)Physical therapist assistants are skilled health care providers who are graduates of a physical therapist assistant associate degree program accredited by an agency recognized by the Secretary of the U.S. Department of Education or Council on Postsecondary Accreditation, who assists the physical therapist in providing physical therapy. The supervising physical therapist is directly responsible for the actions of the physical therapist assistant. The PTA performs physical therapy procedures and related tasks that have been selected and delegated by the supervising physical therapist. Duties of the PTA include assisting the physical therapist in implementing treatment programs, training patients in exercised and activities of daily living, conducting treatments, and reporting to the physical therapist on the patient’s responses. In addition to direct patient care, the PTA may also perform such functions as patient transport, and clinic or equipment preparation and maintenance. Currently more than half of all states require PTAs to be licensed, registered or certified. (2) An individual who works under the supervision of a physical therapist to assist him or her in providing physical therapy services. A physical therapy assistant may, for instance, help patients follow an appropriate exercise program that will increase their strength, endurance, coordination, and range of motion and train patients to perform activities of daily life. |
| Notes: Source: (1) American Physical Therapy Association, P.O. Box 37257, Washington, D.C. 20013. (2) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL: 1994, p. 612 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194265033 | Bryan Gilow | Physical Therapy Assistant | 2617 Zak Ln, Green Bay, WI 54304-1630 | 2017-02-25 |
| 1619365681 | Miranda Marie Hermes | Physical Therapy Assistant | 2305 San Luis Place, Green Bay, WI 54304-5211 | 2014-12-29 |
| 1679904684 | Nicolas Alan Riggs | Physical Therapy Assistant | 2869 Viking Dr, #165, Green Bay, WI 54304-5990 | 2013-12-02 |
| 1770912024 | Jesse Matthew Fitzgerald | Physical Therapy Assistant | 228 Newhall St, Green Bay, WI 54302-1708 | 2013-11-07 |
| 1932542545 | Amy Beth Smedema | Physical Therapy Assistant | 632 S Jackson St, Green Bay, WI 54301-3512 | 2013-04-12 |
| 1417211798 | Audrey Mary Waldschmidt | Physical Therapy Assistant | 1229 S Jackson St, Green Bay, WI 54301-3037 | 2012-07-01 |
| 1326346636 | Melissa Ann Mooren | Physical Therapy Assistant | 2768 Friendly Cir, Green Bay, WI 54313-9533 | 2011-03-10 |
| 1114241288 | Katelyn Mae Servi | Physical Therapy Assistant | 2656 Finger Rd, Green Bay, WI 54302-4821 | 2010-03-18 |
| 1417187154 | Michelle Berkovitz | Physical Therapy Assistant | 2981 Fleetwood Dr, Green Bay, WI 54313-1379 | 2009-07-15 |
| 1508019217 | Brenda Lee Peebles | Physical Therapy Assistant | 546 Gwynn St, Green Bay, WI 54301-1079 | 2008-10-25 |
| Find all providers in GREEN BAY | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.