Individual provider Active NPI

Landry Elliott, OTR

  • Hand Occupational Therapist
  • Glendale, WI
National Provider Identifier
1104534601
Registry record updated Mar 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hand Occupational TherapistTaxonomy code 225XH1200X
License
9005-26 Issued in WI
Practice address
525 W River Woods Pkwy Ste 230
Glendale, WI 53212-1010
Phone
(414) 453-7418
Fax
(414) 967-1151
NPI assigned
Nov 14, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hand Occupational Therapist 225XH1200X 9005-26 WI Primary
Occupational Therapist 225X00000X 9005-26 WI

Addresses

Primary practice location

525 W River Woods Pkwy Ste 230
Glendale, WI 53212-1010

Mailing address

525 W River Woods Pkwy Ste 230
Glendale, WI 53212-1010
Phone (414) 453-7418

Other identifiers 1

IdentifierTypeStateIssuer
9005-26OtherWILICENSE

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

LicenseStateTypeSpecialty
9005-26WIMDHand Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Hand to Shoulder Specialists of Wisconsin LTD Hand PastSince Sep 1, 2024 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1668384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773100800000",
    "number": "1104534601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 W RIVER WOODS PKWY STE 230",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "532121010",
            "telephone_number": "414-453-7418",
            "fax_number": "414-967-1151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 W RIVER WOODS PKWY STE 230",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "532121010",
            "telephone_number": "414-453-7418",
            "fax_number": "414-967-1151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIOTT",
        "first_name": "LANDRY",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-14",
        "last_updated": "2026-03-10",
        "certification_date": "2026-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": "WI",
            "license": "9005-26",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "9005-26",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "9005-26",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2026; 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.