Individual provider Active NPI

Elizabeth Marie Bohn

  • Occupational Therapist
  • West Bend, WI
National Provider Identifier
1063191906
Registry record updated Jul 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
8267-26 Issued in WI
Practice address
620 Schoenhaar Dr
West Bend, WI 53090-2649
Phone
(262) 306-8450
NPI assigned
Jul 17, 2023
Last updated
Jul 17, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2023

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 8267-26 WI Primary

Addresses

Primary practice location

620 Schoenhaar Dr
West Bend, WI 53090-2649

Mailing address

3360 Gateway Rd Ste 100
Brookfield, WI 53045-5115

Other practice location 1

1486 W Mequon Rd
Mequon, WI 53092-3268
Phone (262) 241-8030

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
8267-26WIMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Greenfield Rehabilitation Agency, Inc. Occupational Therapist CurrentSince Jul 23, 2023 Accepting new patients
Rehab Resources Inc PastSince Jul 23, 2023 Accepting new patients

Locations

3360 Gateway Rd
Ste 100
Brookfield, WI 53045
Phone (262) 295-6289

1486 W Mequon Rd
Mequon, WI 53092
Phone (262) 241-8030

620 Schoenhaar Dr
West Bend, WI 53090
Phone (262) 306-8450

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": "1689552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689552000000",
    "number": "1063191906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3360 GATEWAY RD STE 100",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530455115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 SCHOENHAAR DR",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "530902649",
            "telephone_number": "262-306-8450"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1486 W Mequon Rd",
            "address_purpose": "LOCATION",
            "city": "Mequon",
            "state": "WI",
            "postal_code": "530923268",
            "country_code": "US",
            "telephone_number": "262-241-8030",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOHN",
        "first_name": "ELIZABETH",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-17",
        "last_updated": "2023-07-17",
        "certification_date": "2023-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "8267-26",
            "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 Jul 17, 2023; 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.