Maryann Willgrubs, OTR

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

947-026 Issued in WI

Practice address

317 Knutson Dr
Madison, WI 53704-1133

Phone

(608) 301-1968

Fax

(608) 301-9388

NPI assigned

Sep 22, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611187200000",
    "number": "1215036595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "317 KNUTSON DR",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537041133",
            "telephone_number": "608-301-1968",
            "fax_number": "608-301-9388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "317 KNUTSON DR",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537041133",
            "telephone_number": "608-301-1968",
            "fax_number": "608-301-9388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLGRUBS",
        "first_name": "MARYANN",
        "name_prefix": "Mrs.",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-22",
        "last_updated": "2021-01-21",
        "certification_date": "2021-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "WI",
            "license": "947-026",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NBCOT REGISTRATION",
            "identifier": "977355",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40884400",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE CERTIFICATION",
            "identifier": "947-026",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christa Mattson Wille, DPT
• Audrey Willems Van Dijk, RN
• Katie Lynn Willenborg
• Matthew J Willenborg
• Jamie Willes, RBT
• William S. Middleton Memorial VA Hospital
• Hannah Marie William, MD, MPH
• Racquel Williams-Kroll
• Alexandra Williams, RPH
• Benjamin Williams, PT, DPT

• Pediatric Occupational Therapist in Madison, WI
• Providers in Madison, WI by specialty
• Pediatric Occupational Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2021; 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.