Active NPI
Michael Burns, OTA
- Occupational Therapy Assistant
- Madison, WI
National Provider Identifier
1154767796
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 4581-27
- Practice address
- 4288 Severson Dr
Madison, WI 53718-6642 - Phone
- (608) 221-0161
- NPI assigned
- May 21, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 4581-27 | WI | Primary |
| Home Modifications Contractor | 171WH0202X | 4581-27 | WI |
Addresses
Primary practice location
4288 Severson Dr
Madison, WI 53718-6642
Mailing address
4288 Severson Dr
Madison, WI 53718-6642
Phone (608) 221-0161
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
| License | State | Type | Specialty |
|---|---|---|---|
| 4581-27 | WI | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1369094400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1369094400000",
"number": "1154767796",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4288 SEVERSON DR",
"city": "MADISON",
"state": "WI",
"postal_code": "537186642",
"telephone_number": "608-221-0161"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4288 SEVERSON DR",
"city": "MADISON",
"state": "WI",
"postal_code": "537186642",
"telephone_number": "608-221-0161"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURNS",
"first_name": "MICHAEL",
"credential": "OTA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-05-21",
"last_updated": "2013-05-21",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "WI",
"license": "4581-27",
"primary": true
},
{
"code": "171WH0202X",
"taxonomy_group": "",
"desc": "Contractor, Home Modifications",
"state": "WI",
"license": "4581-27",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Madison, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.