Active NPI
Jamie Lynn Mosupye, O.T.
- Occupational Therapist
- Green Bay, WI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 4825-026
- Practice address
- 744 S Webster Ave
Green Bay, WI 54301-3505 - Phone
- (920) 433-7823
- Fax
- (920) 433-3651
- NPI assigned
- Oct 18, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 4825-026 | 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) 445-7210
Other practice location 1
820 Arbutus Ave
Oconto, WI 54153
Phone (920) 835-1100
Other practice location 2
1580 Commanche Ave
Green Bay, WI 54313-5751
Phone (920) 435-8326
Other practice location 3
1630 Commanche Ave
Green Bay, WI 54313-5753
Phone (920) 430-4700
Other practice location 4
3263 Eaton Rd
Green Bay, WI 54311-6830
Phone (920) 433-6700
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013227537 | Medicaid | WI |
Other names 1
- Jamie Lynn Janssen
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4825-026 | WI | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Oconto Hospital & Medical Center Inc | Current | Accepting new patients | |
| Bellin Memorial Hospital Inc | Current | Accepting new patients | |
| Oconto Hospital & Medical Center Inc | Current | Accepting new patients | |
| Oconto Hospital & Medical Center, Inc. | Current | Accepting new patients | |
| Bellin Memorial Hospital Inc. | Current | Accepting new patients | |
| Bellin Memorial Hospital Inc | Occupational Therapist | Current | Accepting new patients |
Locations
2305 San Luis Pl
Green Bay, WI 54304
Phone (920) 494-2817
744 S Webster Ave
Green Bay, WI 54301
Phone (920) 433-6025
1630 Commanche Ave
Green Bay, WI 54313
Phone (920) 430-4700
3263 Eaton Rd
Green Bay, WI 54311
Phone (920) 433-6000
1580 Commanche Ave
Green Bay, WI 54313
Phone (920) 431-5687
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 and National Provider Directory roles.
-
- Rural Health Clinic/Center
- Algoma, WI
- NPI 1609838473
-
- Critical Access Hospital
- Oconto, WI
- NPI 1356373302
-
- Family Medicine Physician
- Green Bay, WI
- NPI 1033172390
Occupational Therapist
-
- General Acute Care Hospital
- Green Bay, WI
- NPI 1891740585
-
- Rural Health Clinic/Center
- Suring, WI
- NPI 1104418037
-
- Rural Health Clinic/Center
- Oconto, WI
- NPI 1609018589
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1287360000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1692576000000",
"number": "1013227537",
"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": "920-445-7210",
"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": "920-433-7823",
"fax_number": "920-433-3651"
}
],
"practiceLocations": [
{
"address_1": "820 Arbutus Ave",
"address_purpose": "LOCATION",
"city": "Oconto",
"state": "WI",
"postal_code": "54153",
"country_code": "US",
"telephone_number": "920-835-1100",
"fax_number": "920-835-1099",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1580 Commanche Ave",
"address_purpose": "LOCATION",
"city": "Green Bay",
"state": "WI",
"postal_code": "543135751",
"country_code": "US",
"telephone_number": "920-435-8326",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1630 Commanche Ave",
"address_purpose": "LOCATION",
"city": "Green Bay",
"state": "WI",
"postal_code": "543135753",
"country_code": "US",
"telephone_number": "920-430-4700",
"fax_number": "920-430-4747",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3263 Eaton Rd",
"address_purpose": "LOCATION",
"city": "Green Bay",
"state": "WI",
"postal_code": "543116830",
"country_code": "US",
"telephone_number": "920-433-6700",
"fax_number": "920-433-6719",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MOSUPYE",
"first_name": "JAMIE",
"middle_name": "LYNN",
"credential": "O.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-10-18",
"last_updated": "2023-08-21",
"certification_date": "2023-08-21",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "WI",
"license": "4825-026",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1013227537",
"state": "WI"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "JAMIE",
"last_name": "JANSSEN",
"middle_name": "LYNN",
"credential": "O.T.",
"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 Aug 21, 2023; 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.