Lacey Ann Roggenbuck, OTR

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

5331-26 Issued in WI

Practice address

1222 E Woodland Ave
Barron, WI 54812-1378

Phone

(715) 537-3166

NPI assigned

Mar 28, 2013

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

Electronic endpoints 1

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.

• Mayo Clinic Health System-Northwest Wisconsin Region, Inc.

  • Critical Access Hospital
  • Barron, WI
  • NPI 1740239557
  NPD (past)

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

{
    "created_epoch": "1364428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599782400000",
    "number": "1265775175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1510",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547021510",
            "telephone_number": "715-838-5222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1222 E WOODLAND AVE",
            "city": "BARRON",
            "state": "WI",
            "postal_code": "548121378",
            "telephone_number": "715-537-3166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGGENBUCK",
        "first_name": "LACEY",
        "middle_name": "ANN",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-28",
        "last_updated": "2020-09-11",
        "certification_date": "2020-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "5331-26",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lroggenbuck355654@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "1222 E Woodland Ave",
            "city": "Barron",
            "state": "WI",
            "country_code": "US",
            "postal_code": "548121378",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Melanie Lynn Potaczek, PA-C
• Angela Lynn Raymond, M.S.
• Sara K. Reinikainen, NP
• Peter D Reisner, MD
• Robin Rivard
• Patrick F Roper, PA-C
• Margaret Elaine Ross, CRNA
• Payton Rudiger, OT
• James A Rugowski, MD
• Lindsey Marie Ruppel, D.O.

• Occupational Therapist in Barron, WI
• Providers in Barron, WI by specialty
• Occupational Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2020; 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.