Paula Bjoralt, OTR

Key facts

NPI

1205936283

Entity type

Individual (NPI type 1)

Primary specialty

Occupational Therapist 225X00000X

License

1553 (WI)

Practice address

39 N 25TH St E
Superior, WI 54880-5269

Phone

(763) 689-5385

Fax

(763) 689-5558

NPI assigned

Sep 22, 2006

Sex

Female

Sole proprietor

No

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

State licenses

Specialties & licenses

Addresses

Other identifiers

Other names

• Paula Herring Other name

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 9, 2007.

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1205936283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2302 JEFFERSON ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558122211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39 N 25TH ST E",
            "city": "SUPERIOR",
            "state": "WI",
            "postal_code": "548805269",
            "telephone_number": "763-689-5385",
            "fax_number": "763-689-5558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BJORALT",
        "first_name": "PAULA",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-22",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "1553",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MN",
            "license": "102999",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "6403351",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41810700",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "111M2BJ",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMPCARE BLUE",
            "identifier": "477564478000",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "HP45702",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PAULA",
            "last_name": "HERRING",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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All providers in Superior, WI · Occupational Therapist in Wisconsin