Susan Ann Dobberpuhl, OTR

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

1841026 Issued in WI

Practice address

306 N Sprint St
Port Washington, WI 53074

Phone

(262) 284-2668

NPI assigned

Nov 21, 2007

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 1

Other names 1

• Ms. Susan Ann Kotecki Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Orlanu Therapies -the Myofascial Release Center of Milwaukee, S.C.

  • Physical Therapist
  • Glendale, WI
  • NPI 1386679900
  NPD (past)

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

{
    "created_epoch": "1195603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196726400000",
    "number": "1235310921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "306 N SPRING ST",
            "city": "PORT WASHINGTON",
            "state": "WI",
            "postal_code": "53074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 N SPRINT ST",
            "city": "PORT WASHINGTON",
            "state": "WI",
            "postal_code": "53074",
            "telephone_number": "262-284-2668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOBBERPUHL",
        "first_name": "SUSAN",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-21",
        "last_updated": "2007-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "1841026",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40864700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSAN",
            "last_name": "KOTECKI",
            "middle_name": "ANN",
            "prefix": "MS.",
            "credential": "ORT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• William A Covelli, DDS
• Courtney Jory Cowen
• Ella Cox
• Samantha Gregory Dagenhardt, RN, MS, MSN, PMHCNS-
• Angela T.M Damrow, PTA
• Kaylee Doll
• James Aaron Doyle, MSHA, ABOC
• Marcy Drummy, MS, LPC
• Marissa Alexandra Duncan, LPC
• Christopher M Eernisse, D.O..

• Occupational Therapist in Port Washington, WI
• Providers in Port Washington, WI by specialty
• Occupational Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 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.

Verify at the official NPI Registry.