Individual provider Active NPI

Sarah Ann Goranson, MS, OTR

  • Occupational Therapist
  • Menasha, WI
National Provider Identifier
1124304050
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
5086-26 Issued in WI
Practice address
1700 Midway Rd
Menasha, WI 54952-1230
Phone
(920) 739-0111
NPI assigned
Oct 24, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X
Occupational Therapist 225X00000X 5086-26 WI Primary

Addresses

Primary practice location

1700 Midway Rd
Menasha, WI 54952-1230

Mailing address

W6014 Coral CT
Appleton, WI 54915-7425
Phone (920) 475-1579

Other practice location 1

1436 S Lincoln St
Shawano, WI 54166-3427
Phone (715) 526-6111

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
5086-26WIMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1319414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1124304050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W6014 CORAL CT",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549157425",
            "telephone_number": "920-475-1579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 MIDWAY RD",
            "city": "MENASHA",
            "state": "WI",
            "postal_code": "549521230",
            "telephone_number": "920-739-0111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1436 S Lincoln St",
            "address_purpose": "LOCATION",
            "city": "Shawano",
            "state": "WI",
            "postal_code": "541663427",
            "country_code": "US",
            "telephone_number": "715-526-6111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GORANSON",
        "first_name": "SARAH",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "MS, OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-24",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "5086-26",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Menasha, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 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.