Active NPI
Morgan Eileen Wellenzohn, OTR/L
- Occupational Therapist
- Ketchikan, AK
National Provider Identifier
1225733595
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 207441
- Practice address
- 4079 Tongass Ave Ste 102
Ketchikan, AK 99901-5559 - Phone
- (907) 225-7808
- NPI assigned
- Apr 4, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 207441 | AK | Primary |
| Occupational Therapist | 225X00000X | 478217 | OR | |
| Occupational Therapist | 225X00000X | OT61373616 | WA |
Addresses
Primary practice location
4079 Tongass Ave Ste 102
Ketchikan, AK 99901-5559
Mailing address
655 S Willow St Ste 128
Manchester, NH 03103-5723
Phone (800) 995-2673
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 207441 | AK | MD | Occupational Therapist |
| 478217 | OR | MD | Occupational Therapist |
| OT61373616 | WA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1680566400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1680566400000",
"number": "1225733595",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "655 S WILLOW ST STE 128",
"city": "MANCHESTER",
"state": "NH",
"postal_code": "031035723",
"telephone_number": "800-995-2673",
"fax_number": "888-979-6551"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4079 TONGASS AVE STE 102",
"city": "KETCHIKAN",
"state": "AK",
"postal_code": "999015559",
"telephone_number": "907-225-7808"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WELLENZOHN",
"first_name": "MORGAN",
"middle_name": "EILEEN",
"credential": "OTR/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-04-04",
"last_updated": "2023-04-04",
"certification_date": "2023-03-27",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "AK",
"license": "207441",
"primary": true
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "OR",
"license": "478217",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "WA",
"license": "OT61373616",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Ketchikan, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.