Active NPI
Karen Marie Jakubek
- Occupational Therapy Assistant
- Appleton, WI
National Provider Identifier
1053579375
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 100-027
- Practice address
- 601 N Briarcliff Dr
Appleton, WI 54915-2959 - Phone
- (920) 739-4466
- NPI assigned
- May 23, 2008
- Sex
- Female
- Sole proprietor
- Yes
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 Therapy Assistant | 224Z00000X | 100-027 | Primary |
Addresses
Primary practice location
601 N Briarcliff Dr
Appleton, WI 54915-2959
Mailing address
601 N Briarcliff Dr
Appleton, WI 54915-2959
Phone (920) 739-4466
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 40752300 | Medicaid | WI |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1211500800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1211500800000",
"number": "1053579375",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "601 N BRIARCLIFF DR",
"city": "APPLETON",
"state": "WI",
"postal_code": "549152959",
"telephone_number": "920-739-4466"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "601 N BRIARCLIFF DR",
"city": "APPLETON",
"state": "WI",
"postal_code": "549152959",
"telephone_number": "920-739-4466"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JAKUBEK",
"first_name": "KAREN",
"middle_name": "MARIE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-05-23",
"last_updated": "2008-05-23",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": null,
"license": "100-027",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "40752300",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Appleton, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.