Individual provider Active NPI

Ellie Jean McMeeken, OTR/L

  • Occupational Therapist
  • West Bend, WI
National Provider Identifier
1013771419
Registry record updated Feb 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Practice address
1700 W Paradise Dr
West Bend, WI 53095-9795
Phone
(262) 334-3451
NPI assigned
Feb 7, 2024
Last updated
Feb 7, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2024

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 NU Primary

Addresses

Primary practice location

1700 W Paradise Dr
West Bend, WI 53095-9795

Mailing address

6330 Aurora Rd
West Bend, WI 53095-9172
Phone (262) 305-5183

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240405003657 WI Practitioner - Occupational Therapist in Private Practice 3173961331 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1700 W Paradise Dr
West Bend, WI 53095-9795
Phone (262) 334-3451

W168N11237 Western Ave
Germantown, WI 53022-3239
Phone (262) 253-5060

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince Mar 29, 2024 Accepting new patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince Mar 29, 2024 Accepting new patients

Locations

W168N11237 Western Ave
Germantown, WI 53022
Phone (262) 253-5060

N74W12501 Leatherwood Ct
Menomonee Falls, WI 53051
Phone (414) 454-4744

1155 N Mayfair Rd
Wauwatosa, WI 53226
Phone (414) 955-5990

1700 W Paradise Dr
West Bend, WI 53095
Phone (262) 334-3451

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": "1707264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707264000000",
    "number": "1013771419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6330 AURORA RD",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "530959172",
            "telephone_number": "262-305-5183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 W PARADISE DR",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "530959795",
            "telephone_number": "262-334-3451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMEEKEN",
        "first_name": "ELLIE",
        "middle_name": "JEAN",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-07",
        "last_updated": "2024-02-07",
        "certification_date": "2024-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Bend, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.