Active NPI
Ellen Pestcoe, OTR
- Occupational Therapist
- Gays Mills, WI
National Provider Identifier
1174912992
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 1714-26
- Practice address
- 43188 Guthrie Rd
Gays Mills, WI 54631-8266 - Phone
- (608) 872-2407
- NPI assigned
- Jan 16, 2015
- Last updated
- Jan 16, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 1714-26 | WI | Primary |
Addresses
Primary practice location
43188 Guthrie Rd
Gays Mills, WI 54631-8266
Mailing address
507 S .Main St.
Vernon Memorial Healthcare
Viroqua, WI 54665
Phone (608) 637-4385
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 |
|---|---|---|---|
| 1714-26 | WI | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1421366400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1421366400000",
"number": "1174912992",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "507 S .MAIN ST.",
"address_2": "VERNON MEMORIAL HEALTHCARE",
"city": "VIROQUA",
"state": "WI",
"postal_code": "54665",
"telephone_number": "608-637-4385",
"fax_number": "608-637-4382"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "43188 GUTHRIE RD",
"city": "GAYS MILLS",
"state": "WI",
"postal_code": "546318266",
"telephone_number": "608-872-2407"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PESTCOE",
"first_name": "ELLEN",
"name_prefix": "Ms.",
"credential": "OTR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-01-16",
"last_updated": "2015-01-16",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "WI",
"license": "1714-26",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gays Mills, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 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.