Individual provider Active NPI

Brooke Alise Ebersole, OPT

  • Occupational Therapist
  • Warsaw, IN
National Provider Identifier
1164346391
Registry record updated Aug 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
31009149A Issued in IN
Practice address
3300 Lake City Hwy
Warsaw, IN 46580-3923
Phone
(574) 306-2912
NPI assigned
Aug 10, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 31009149A IN Primary

Addresses

Primary practice location

3300 Lake City Hwy
Warsaw, IN 46580-3923

Mailing address

3300 Lake City Hwy
Warsaw, IN 46580-3923
Phone (574) 306-2912

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

NPI Registry JSON

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

{
    "created_epoch": "1786320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786320000000",
    "number": "1164346391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 LAKE CITY HWY",
            "city": "WARSAW",
            "state": "IN",
            "postal_code": "465803923",
            "telephone_number": "574-306-2912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 LAKE CITY HWY",
            "city": "WARSAW",
            "state": "IN",
            "postal_code": "465803923",
            "telephone_number": "574-306-2912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBERSOLE",
        "first_name": "BROOKE",
        "middle_name": "ALISE",
        "credential": "OPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-08-10",
        "last_updated": "2026-08-10",
        "certification_date": "2026-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IN",
            "license": "31009149A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warsaw, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2026; 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.