Individual provider Active NPI

Jack William Pamperin

  • Occupational Therapist
  • Plover, WI
National Provider Identifier
1013531870
Registry record updated Jun 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
6584-26 Issued in WI
Practice address
3021 Patton Dr
Plover, WI 54467-2642
Phone
(715) 544-2322
NPI assigned
Jun 7, 2020
Last updated
Jun 7, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 6584-26 WI Primary

Addresses

Primary practice location

3021 Patton Dr
Plover, WI 54467-2642

Mailing address

924 Songbird LN Unit J5
Stevens Point, WI 54482-8652
Phone (920) 841-1543

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6584-26WIMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Transitions at Home, Inc. PastSince Jun 14, 2020 Accepting new patients
Transitions at Home, Inc. PastSince Jun 14, 2020 Accepting new patients

Organizations & group practices 2

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": "1591488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591488000000",
    "number": "1013531870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "924 SONGBIRD LN UNIT J5",
            "city": "STEVENS POINT",
            "state": "WI",
            "postal_code": "544828652",
            "telephone_number": "920-841-1543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3021 PATTON DR",
            "city": "PLOVER",
            "state": "WI",
            "postal_code": "544672642",
            "telephone_number": "715-544-2322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAMPERIN",
        "first_name": "JACK",
        "middle_name": "WILLIAM",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-07",
        "last_updated": "2020-06-07",
        "certification_date": "2020-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "6584-26",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plover, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2020; 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.