Individual provider Active NPI

Amy Stoddard, COTA

  • Occupational Therapy Assistant
  • MC Farland, WI
National Provider Identifier
1184856833
Registry record updated Aug 13, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
1911-027 Issued in WI
Practice address
5979 Siggelkow Rd
MC Farland, WI 53558-9817
Phone
(608) 838-8999
NPI assigned
Aug 13, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 1911-027 WI Primary

Addresses

Primary practice location

5979 Siggelkow Rd
MC Farland, WI 53558-9817

Mailing address

5320 Schluter Rd
Monona, WI 53716-3018
Phone (608) 770-6732

Other identifiers 1

IdentifierTypeStateIssuer
42255100MedicaidWI

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

LicenseStateTypeSpecialty
1911-027WIMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Common Threads Family Resource Center Past Accepting new patients
Catholic Charities, Inc. Roman Catholic Diocese Past Accepting new patients

Organizations & group practices 2

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": "1250121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1250121600000",
    "number": "1184856833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5320 SCHLUTER RD",
            "city": "MONONA",
            "state": "WI",
            "postal_code": "537163018",
            "telephone_number": "608-770-6732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5979 SIGGELKOW RD",
            "city": "MC FARLAND",
            "state": "WI",
            "postal_code": "535589817",
            "telephone_number": "608-838-8999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STODDARD",
        "first_name": "AMY",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-13",
        "last_updated": "2009-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "WI",
            "license": "1911-027",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "42255100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in MC Farland, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2009; 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.