Badieh Widmer, OTR

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

3207-026 Issued in WI

Practice address

N546 Schroeter Dr
Random Lake, WI 53075-1272

Phone

(920) 207-3550

Fax

(920) 994-4606

NPI assigned

Dec 8, 2006

Last updated

Jan 3, 2025By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Phoenix Mountain Therapy LLC

  dba Phoenix Mountain Therapy

  • Physical Therapist
  • Scottsdale, AZ
  • NPI 1053122689

  Occupational Therapist

  Medicare reassignment NPD
• Mueller Therapy, Inc.

  • Occupational Therapist
  • Random Lake, WI
  • NPI 1578515755
  NPD (past)

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

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735862400000",
    "number": "1114086881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N546 SCHROETER DR",
            "city": "RANDOM LAKE",
            "state": "WI",
            "postal_code": "530751272",
            "telephone_number": "920-207-3550",
            "fax_number": "920-994-4606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N546 SCHROETER DR",
            "city": "RANDOM LAKE",
            "state": "WI",
            "postal_code": "530751272",
            "telephone_number": "920-207-3550",
            "fax_number": "920-994-4606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIDMER",
        "first_name": "BADIEH",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-08",
        "last_updated": "2025-01-03",
        "certification_date": "2025-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "3207-026",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jill Shea Suess, OTR
• Elizabeth Marie Theis
• Brenda M Veldboom, NP
• Gerald Linus Vogler, DDS
• Barbara Alice Weber, MD
• Amie L Wilson, OTR

• Occupational Therapist in Random Lake, WI
• Providers in Random Lake, WI by specialty
• Occupational Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.