Active NPI
Abigail N Good, OT
- Occupational Therapist
- Green Bay, WI
National Provider Identifier
1073075503
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 6479-26
- Practice address
- 725 S Webster Ave
Green Bay, WI 54301-3500 - Phone
- (920) 433-3655
- Fax
- (920) 433-3539
- NPI assigned
- Apr 3, 2019
- Last updated
- Aug 12, 2021
- Sex
- Female
- Sole proprietor
- No
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 Therapist | 225X00000X | 6479-26 | WI | Primary |
Addresses
Primary practice location
725 S Webster Ave
Green Bay, WI 54301-3500
Mailing address
PO Box 22487
Green Bay, WI 54305-2487
Phone (920) 445-7222
Other practice location 1
1000 Mineral Point Ave
Janesville, WI 53548-2940
Phone (608) 756-6842
Other practice location 2
N2950 State Road 67
Lake Geneva, WI 53147-2655
Phone (262) 245-4990
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 416913 | Other | NATIONAL BOARD CERTIFICATION IN OCCUPATIONAL THERAPY |
Other names 1
- Abigail N Kirchman
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1554249600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1628726400000",
"number": "1073075503",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 22487",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "543052487",
"telephone_number": "920-445-7222",
"fax_number": "920-445-7289"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "725 S WEBSTER AVE",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "543013500",
"telephone_number": "920-433-3655",
"fax_number": "920-433-3539"
}
],
"practiceLocations": [
{
"address_1": "1000 Mineral Point Ave",
"address_purpose": "LOCATION",
"city": "Janesville",
"state": "WI",
"postal_code": "535482940",
"country_code": "US",
"telephone_number": "608-756-6842",
"fax_number": "608-741-6953",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "N2950 State Road 67",
"address_purpose": "LOCATION",
"city": "Lake Geneva",
"state": "WI",
"postal_code": "531472655",
"country_code": "US",
"telephone_number": "262-245-4990",
"fax_number": "262-245-2248",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GOOD",
"first_name": "ABIGAIL",
"middle_name": "N",
"credential": "OT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-04-03",
"last_updated": "2021-08-12",
"certification_date": "2021-08-12",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "WI",
"license": "6479-26",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NATIONAL BOARD CERTIFICATION IN OCCUPATIONAL THERAPY",
"identifier": "416913",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"first_name": "ABIGAIL",
"last_name": "KIRCHMAN",
"middle_name": "N",
"credential": "OT",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Green Bay, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.