Individual provider Active NPI

Faith Demunck

  • Occupational Therapist
  • Sheboygan, WI
National Provider Identifier
1194564500
Registry record updated May 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
853426 Issued in WI
Practice address
2912 S Business Dr
Sheboygan, WI 53081-6520
Phone
(920) 803-2179
NPI assigned
May 23, 2024
Last updated
May 31, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2024

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 853426 WI Primary

Addresses

Primary practice location

2912 S Business Dr
Sheboygan, WI 53081-6520

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240618001106 WI Practitioner - Occupational Therapist in Private Practice 7911440037 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1365 -1367 Port Washington Rd
Grafton, WI 53024-9333
Phone (262) 474-0050

S74W16845 Janesville Rd
Muskego, WI 53150-8618
Phone (262) 971-4200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
853426WIMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Athletic & Therapeutic Institute of Milwaukee LLC CurrentSince May 28, 2024 Accepting new patients
Athletic & Therapeutic Institute of Milwaukee, LLC Occupational Therapist CurrentSince May 28, 2024 Accepting new patients
Athletic & Therapeutic Institute of Milwaukee, LLC Occupational Therapist Current Accepting new patients
Athletic & Therapeutic Institute of Milwaukee, LLC PastSince May 26, 2024 Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

S74W16867 Janesville Rd
Muskego, WI 53150
Phone (262) 971-4200

2809 S Business Dr
Sheboygan, WI 53081
Phone (920) 803-2179

2912 S Business Dr
Sheboygan, WI 53081
Phone (920) 803-2179

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1716422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717113600000",
    "number": "1194564500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2912 S BUSINESS DR",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530816520",
            "telephone_number": "920-803-2179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMUNCK",
        "first_name": "FAITH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-23",
        "last_updated": "2024-05-31",
        "certification_date": "2024-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "853426",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sheboygan, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.