Melissa Herbst, COTA

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

Practice address

425 Davis St
Hammond, WI 54015-9615

Phone

(715) 796-2218

NPI assigned

Jan 12, 2015

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1421020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421020800000",
    "number": "1134518459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "718 WALDROFF FARM RD",
            "city": "HUDSON",
            "state": "WI",
            "postal_code": "540167685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 DAVIS ST",
            "city": "HAMMOND",
            "state": "WI",
            "postal_code": "540159615",
            "telephone_number": "715-796-2218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERBST",
        "first_name": "MELISSA",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-12",
        "last_updated": "2015-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• FMG Davis Street SNF Wisconsin LLC
• Crystal Friske, C.O.T.A.
• Amy Elizabeth Gierl, CFY-SLP
• Gilhousen Chiropractic Health & Sports Center
• Michael Richard Gilhousen, D.C.
• Michelle R Hoops, OTR/L
• Karla Lynn Jacobson, COTA
• Breauanna Nina Jennings, COTA
• Angela Rose Kjellberg, COTA
• Joyanne Marie Kohler

• All providers in Hammond, WI
• Occupational Therapy Assistant in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2015; 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.