Teri Ann Henderson, COTA

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

1646-027 Issued in WI

Practice address

250 Lawrence Ave
Park Falls, WI 54552-1431

Phone

(715) 762-2449

NPI assigned

May 1, 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 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• NSH Rib Lake LLC

  • Skilled Nursing Facility
  • Rib Lake, WI
  • NPI 1831631704
  NPD (past)

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1114148756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N7953 WILSON LAKE RD",
            "city": "PHILLIPS",
            "state": "WI",
            "postal_code": "545556740",
            "telephone_number": "715-339-3221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 LAWRENCE AVE",
            "city": "PARK FALLS",
            "state": "WI",
            "postal_code": "545521431",
            "telephone_number": "715-762-2449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "TERI",
        "middle_name": "ANN",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-01",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "WI",
            "license": "1646-027",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40877100",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OT ASSISTANT",
            "identifier": "1646-027",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anna Lynn Goetz, DDS
• Glenn Wolfgang Haidinger, DMD
• Gina Georgeann Hansen, DMD
• Geoffrey S Harrison, MD
• Health Managment Consortium
• Diondra K Hilgart, COTA
• Raj Purshotam Hiranandani, M.D.
• Robert Hubers, MD
• Simon Huynh, DDS
• Amanda A Jackson, NP

• All providers in Park Falls, WI
• 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.