Individual provider Active NPI

Amber Londt, O.T.R., P.T.A.

  • Occupational Therapist
  • Brookfield, WI
National Provider Identifier
1174773527
Registry record updated Sep 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
4466-026 Issued in WI
Practice address
275 Regency CT
Suite 200
Brookfield, WI 53045-6168
Phone
(262) 798-9650
Fax
(262) 798-9652
NPI assigned
Sep 23, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2008

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 267-019 WI
Physical Therapy Assistant 225200000X 06002835A IN
Occupational Therapist 225X00000X 4466-026 WI Primary
Occupational Therapist 225X00000X 31004485A IN

Addresses

Primary practice location

275 Regency CT
Suite 200
Brookfield, WI 53045-6168

Mailing address

275 Regency CT
Suite 200
Brookfield, WI 53045-6168
Phone (262) 798-9650

Other identifiers 4

IdentifierTypeStateIssuer
31004485AOtherINOCCUPATIONAL THERAPIST INDIANA LICENSE
4466-026OtherWIOCCUPATIONAL THERAPIST STATE LICENSE/PTA STATE LICENSE
06002835AOtherINPTA INDIANA LICENSE
267-019OtherWIPTA STATE LICENSE

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
06002835AINMDPhysical Therapy Assistant
267-019WIMDPhysical Therapy Assistant
31004485AINMDOccupational Therapist
4466-026WIMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Rehabilitation Institute of Wisconsin, Inc. PastSince Feb 10, 2011 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1222128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222128000000",
    "number": "1174773527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 REGENCY CT",
            "address_2": "SUITE 200",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530456168",
            "telephone_number": "262-798-9650",
            "fax_number": "262-798-9652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 REGENCY CT",
            "address_2": "SUITE 200",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530456168",
            "telephone_number": "262-798-9650",
            "fax_number": "262-798-9652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONDT",
        "first_name": "AMBER",
        "credential": "O.T.R., P.T.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-23",
        "last_updated": "2008-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WI",
            "license": "267-019",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IN",
            "license": "06002835A",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "4466-026",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IN",
            "license": "31004485A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OCCUPATIONAL THERAPIST INDIANA LICENSE",
            "identifier": "31004485A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OCCUPATIONAL THERAPIST STATE LICENSE/PTA STATE LICENSE",
            "identifier": "4466-026",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTA INDIANA LICENSE",
            "identifier": "06002835A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTA STATE LICENSE",
            "identifier": "267-019",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookfield, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2008; 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.