Individual provider Active NPI

Ann Lynette Hellickson, COTA

  • Occupational Therapy Assistant
  • Middleton, WI
National Provider Identifier
1053588186
Registry record updated Mar 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
98 Issued in WI
Practice address
6201 Elmwood Avenue
Middleton, WI 53562-3319
Phone
(608) 830-5141
Fax
(866) 290-9061
NPI assigned
May 8, 2008
Last updated
Mar 6, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 6, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X
Occupational Therapy Assistant 224Z00000X 98 WI Primary

Addresses

Primary practice location

6201 Elmwood Avenue
Middleton, WI 53562-3319

Mailing address

508 Nottingham Rd
Stoughton, WI 53589-4843
Phone (608) 831-8300

Other practice location 1

6201 Elmwood Avwnue
Middleton Village
Middleton, WI 53562
Phone (608) 831-8300

Other names 1

  • Ms. Ann Lynette Hellickson Former name

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
98WIMDOccupational Therapy Assistant

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1210204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520294400000",
    "number": "1053588186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "508 NOTTINGHAM RD",
            "city": "STOUGHTON",
            "state": "WI",
            "postal_code": "535894843",
            "telephone_number": "608-831-8300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6201 ELMWOOD AVENUE",
            "city": "MIDDLETON",
            "state": "WI",
            "postal_code": "535623319",
            "telephone_number": "608-830-5141",
            "fax_number": "866-290-9061"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6201 Elmwood Avwnue",
            "address_2": "Middleton Village",
            "address_purpose": "LOCATION",
            "city": "Middleton",
            "state": "WI",
            "postal_code": "53562",
            "country_code": "US",
            "telephone_number": "608-831-8300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HELLICKSON",
        "first_name": "ANN",
        "middle_name": "LYNETTE",
        "name_prefix": "Ms.",
        "credential": "COTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-08",
        "last_updated": "2018-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "WI",
            "license": "98",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANN",
            "last_name": "HELLICKSON",
            "middle_name": "LYNETTE",
            "prefix": "MS.",
            "credential": "COTA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Middleton, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2018; 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.