Individual provider Active NPI

Cheryl R. Petrus, OTR

  • Occupational Therapist
  • Ladysmith, WI
National Provider Identifier
1184630618
Registry record updated Jul 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
3960 Issued in WI
Practice address
1200 Port Arthur Rd
Ladysmith, WI 54848-1137
Phone
(715) 532-0987
NPI assigned
Aug 1, 2006
Last updated
Jul 10, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2023

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 3960 WI Primary

Addresses

Primary practice location

1200 Port Arthur Rd
Ladysmith, WI 54848-1137

Mailing address

1000 N Oak Avenue
Marshfield, WI 54449-5703
Phone (715) 389-0632

Other identifiers 1

IdentifierTypeStateIssuer
40875200MedicaidWI

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address him@marshfieldclinichealthsystem.cernerdirect.com Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211129002412 WI Practitioner - Occupational Therapist in Private Practice 3476943812 Reassigns benefits to 9 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Hospital Inc CurrentSince Jun 10, 2023 Accepting new patients
Lakeview Medical Center Inc of Rice Lake CurrentSince Jun 10, 2023 Accepting new patients
MCHS Hospitals Inc CurrentSince Nov 29, 2021 Accepting new patients
Flambeau Hospital Inc CurrentSince Jun 10, 2023 Accepting new patients
Beaver Dam Community Hospitals Inc CurrentSince Jun 10, 2023 Accepting new patients
Memorial Hospital Inc CurrentSince Jun 10, 2023 Accepting new patients
MCHS Hospitals Inc CurrentSince Nov 29, 2021 Accepting new patients
Lakeview Medical Center Inc of Rice Lake CurrentSince Jun 10, 2023 Accepting new patients
Flambeau Hospital Inc CurrentSince Jun 10, 2023 Accepting new patients
Marshfield Clinic Inc CurrentSince Nov 29, 2021 Accepting new patients
MCHS Hospitals Inc Current Accepting new patients
Beaver Dam Community Hospitals Inc CurrentSince Jun 10, 2023 Accepting new patients
Memorial Hospital Inc Past Accepting new patients

Locations

705 S University Ave
Beaver Dam, WI 53916
Phone (920) 885-6090

3501 Golf Rd
Eau Claire, WI 54701
Phone (715) 858-4200

1200 Port Arthur Rd
Ladysmith, WI 54848
Phone (715) 532-2300

900 College Ave W
Ladysmith, WI 54848
Phone (715) 532-5561

1000 N Oak Ave
Marshfield, WI 54449
Phone (715) 387-5111

1102 S Center Ave
Merrill, WI 54452
Phone (715) 536-3399

N3708 River Ave
Neillsville, WI 54456
Phone (715) 743-3101

1700 W Stout St
Rice Lake, WI 54868
Phone (715) 236-6133

Interoperability endpoints

  • Direct secure messaging: him@marshfieldclinichealthsystem.cernerdirect.com

Organizations & group practices 13

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688947200000",
    "number": "1184630618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 N OAK AVENUE",
            "city": "MARSHFIELD",
            "state": "WI",
            "postal_code": "544495703",
            "telephone_number": "715-389-0632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 PORT ARTHUR RD",
            "city": "LADYSMITH",
            "state": "WI",
            "postal_code": "548481137",
            "telephone_number": "715-532-0987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRUS",
        "first_name": "CHERYL",
        "middle_name": "R.",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-01",
        "last_updated": "2023-07-10",
        "certification_date": "2023-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "3960",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40875200",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "him@marshfieldclinichealthsystem.cernerdirect.com",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Other",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Other",
            "address_1": "1000 N Oak Ave",
            "city": "Marshfield",
            "state": "WI",
            "country_code": "US",
            "postal_code": "544495703",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Ladysmith, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.