Tammie Eileen Demicco, COTA

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

1812-027 Issued in WI

Practice address

1922 County Rd. NN
Elkhorn, WI 53121

Phone

(262) 741-3630

Fax

(262) 743-1855

NPI assigned

Apr 23, 2007

Last updated

Jul 8, 2007By the provider in NPPES

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

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": "1177286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245458140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 WILDWOOD CT UNIT D",
            "city": "WILLIAMS BAY",
            "state": "WI",
            "postal_code": "531919647",
            "telephone_number": "262-245-0219",
            "fax_number": "262-728-7129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1922 COUNTY RD. NN",
            "city": "ELKHORN",
            "state": "WI",
            "postal_code": "53121",
            "telephone_number": "262-741-3630",
            "fax_number": "262-743-1855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMICCO",
        "first_name": "TAMMIE",
        "middle_name": "EILEEN",
        "name_prefix": "Miss",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "WI",
            "license": "1812-027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew Alan Dahlgren, M.D.
• Heather Dawn Dalton, D.C.
• Tonya Jean David, MS,CCC-SLP/L
• Lora Renee Defranco, LPC
• Matthew Degroot, DO
• Peter S Diamond, M.D.
• Jessica Christine Doherty, MSW, LCSW, CSAC
• Liza Jayne Drake, LCSW
• Amanda Marie Duckworth, RDH
• Stephenie Duelge, APNP, FNP-BC

• Occupational Therapy Assistant in Elkhorn, WI
• Providers in Elkhorn, WI by specialty
• Occupational Therapy Assistant in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.