Deanna P Doraiswamy, OT

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

0119005787 Issued in VA

Practice address

2961 Saint Anthony Dr
Green Bay, WI 54311

Phone

(920) 468-0861

NPI assigned

Mar 13, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1331596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528934400000",
    "number": "1104191824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2060 E PLANK RD UNIT 3",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549157045",
            "telephone_number": "920-655-7340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2961 SAINT ANTHONY DR",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "54311",
            "telephone_number": "920-468-0861"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8111 Tis Well Dr",
            "address_purpose": "LOCATION",
            "city": "Alexandria",
            "state": "VA",
            "postal_code": "223063211",
            "country_code": "US",
            "telephone_number": "703-373-3494",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DORAISWAMY",
        "first_name": "DEANNA",
        "middle_name": "P",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-13",
        "last_updated": "2018-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "4982-026",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "VA",
            "license": "0119005787",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Megan Domnick
• Breyan Donath-Skeen
• Sarah Beth Donovan, LPC
• Elizabeth Ann Doornink, APRN
• Paulette J Doperalski, CFA
• Jolene Dorn, RDN
• Lorie S Dorn, AU.D.
• Paige M Dorn, MSW, APSW
• John Paul Dorner, PHARMD
• Sara Dorow

• Occupational Therapist in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Occupational Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2018; 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.