Active NPI
Mary Frances Bernadette, MOTR,/LOTR
- Occupational Therapist
- Port Washington, WI
National Provider Identifier
1225228596
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 3764026
- Practice address
- 128 E Kane St
Port Washington, WI 53074-1625 - Phone
- (262) 268-0609
- NPI assigned
- Aug 1, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 3764026 | WI | Primary |
Addresses
Primary practice location
128 E Kane St
Port Washington, WI 53074-1625
Mailing address
128 E Kane St
Port Washington, WI 53074-1625
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 41039600 | Medicaid | WI |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 3764026 | WI | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1185926400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1185926400000",
"number": "1225228596",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "128 E KANE ST",
"city": "PORT WASHINGTON",
"state": "WI",
"postal_code": "530741625"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "128 E KANE ST",
"city": "PORT WASHINGTON",
"state": "WI",
"postal_code": "530741625",
"telephone_number": "262-268-0609"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERNADETTE",
"first_name": "MARY",
"middle_name": "FRANCES",
"name_prefix": "Ms.",
"credential": "MOTR,/LOTR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-08-01",
"last_updated": "2007-08-01",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "WI",
"license": "3764026",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "41039600",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Port Washington, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.