Active NPI
Stephanie Rutkowski
- Occupational Therapy Assistant
- Brookfield, WI
National Provider Identifier
1083282172
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 5742
- Practice address
- 17700 W Capitol Dr
Brookfield, WI 53045-2006 - Phone
- (262) 781-3083
- NPI assigned
- Jun 15, 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 Therapy Assistant | 224Z00000X | 5742 | WI | Primary |
Addresses
Primary practice location
17700 W Capitol Dr
Brookfield, WI 53045-2006
Mailing address
17700 W Capitol Dr
Brookfield, WI 53045-2006
Phone (262) 781-3083
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://auth.webpt.com/ |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 5742 | WI | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1623715200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1623715200000",
"number": "1083282172",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17700 W CAPITOL DR",
"city": "BROOKFIELD",
"state": "WI",
"postal_code": "530452006",
"telephone_number": "262-781-3083"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17700 W CAPITOL DR",
"city": "BROOKFIELD",
"state": "WI",
"postal_code": "530452006",
"telephone_number": "262-781-3083"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUTKOWSKI",
"first_name": "STEPHANIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-06-15",
"last_updated": "2021-06-15",
"certification_date": "2021-06-15",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "WI",
"license": "5742",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "https://auth.webpt.com/",
"affiliation": "N",
"address_1": "17700 W Capitol Dr",
"city": "Brookfield",
"state": "WI",
"country_code": "US",
"postal_code": "530452006",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Brookfield, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 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.