Melanie Grace Petersen, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

5155-26 Issued in WI

Practice address

5979 Siggelkow Rd
MC Farland, WI 53558-9817

Phone

(608) 838-8999

NPI assigned

Mar 8, 2012

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

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.

• Catholic Charities, Inc. Roman Catholic Diocese

  • Community/Behavioral Health Agency
  • MC Farland, WI
  • NPI 1962752402
  NPD (past)
• Common Threads Family Resource Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Madison, WI
  • NPI 1386808384

  Occupational Therapist

  NPD (past)

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

{
    "created_epoch": "1331164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331164800000",
    "number": "1255606281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 METRO TER UNIT 109",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537186424",
            "telephone_number": "608-243-9242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5979 SIGGELKOW RD",
            "city": "MC FARLAND",
            "state": "WI",
            "postal_code": "535589817",
            "telephone_number": "608-838-8999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "MELANIE",
        "middle_name": "GRACE",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-08",
        "last_updated": "2012-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "5155-26",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Quick Fix After Hours Chiropractic Care, LLC
• Debra L Raasch, APNP
• Carly Rae Kazmerzak Ramthun, MA, MT-BC, CTP
• Sara Rundhaug
• Kimberly Anne Schmidt, M.S.

• Occupational Therapist in MC Farland, WI
• Providers in MC Farland, WI by specialty
• Occupational Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2012; 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.