Susan Laura Pribyl, C.O.T.A.

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

502-027 Issued in WI

Practice address

5000 Memorial Dr
Two Rivers, WI 54241-3900

Phone

(920) 794-5176

Fax

(920) 794-5472

NPI assigned

Mar 8, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Susan Laura Wurth Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1093846339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "E1097 PRIBYL RD",
            "city": "DENMARK",
            "state": "WI",
            "postal_code": "542087767",
            "telephone_number": "920-776-1095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 MEMORIAL DR",
            "city": "TWO RIVERS",
            "state": "WI",
            "postal_code": "542413900",
            "telephone_number": "920-794-5176",
            "fax_number": "920-794-5472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRIBYL",
        "first_name": "SUSAN",
        "middle_name": "LAURA",
        "credential": "C.O.T.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-08",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "WI",
            "license": "502-027",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40271900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSAN",
            "last_name": "WURTH",
            "middle_name": "LAURA",
            "credential": "C.O.T.A.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Allison Pierce, LAT
• Jodi Lynn Platner, M.S. BCBA
• Ada Popovic, BCBA, LBA
• Charles D Pratt, MD
• Joy Lynn Preston, PTA
• Elizabeth M Propson, RN
• Theresa Marie Prucha, O.T.R. C.H.T.
• Reece Quistorf
• Michael J Rademacher, COTA
• Douglas E Rapisarda, MD

• Occupational Therapy Assistant in Two Rivers, WI
• Providers in Two Rivers, WI by specialty
• Occupational Therapy Assistant in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.