Amelia Pearl King, COTA/L

Individual provider Active NPI Occupational Therapy Assistant · Luck, WI

NPI 1073486007 · NPPES record last updated Sep 25, 2025

Key facts

NPI
1073486007
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
License
7268-27 (WI)
Practice address
623 S 2ND St
Luck, WI 54853-9070
Phone
(715) 472-2164
NPI assigned
Sep 25, 2025
Sex
Female
Sole proprietor
No

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 and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
202937MNMDOccupational Therapy Assistant
7268-27WIMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Greenfield Rehabilitation Agency, Inc. Current
since Sep 28, 2025
Accepting new patients
Greenfield Rehabilitation Agency, Inc. Current
since Sep 28, 2025
Accepting new patients

Locations

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

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 202937 MN
Occupational Therapy Assistant 224Z00000X 7268-27 WI Yes

Addresses

Primary practice location

623 S 2ND St
Luck, WI 54853-9070

Mailing address

3360 Gateway Rd Ste 100
Brookfield, WI 53045-5115
Phone (262) 923-7101

Other practice location 1

205 United Way
Frederic, WI 54837-8938
Phone (715) 327-4297

Other providers in Luck, WI

All providers in Luck, WI · Occupational Therapy Assistant in Wisconsin

Sources for this page

Verify at the official NPI Registry.