Jennifer Marie Costigan, OTR

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

3283026 Issued in WI

Practice address

18740 W Bluemound Road
Brookfield, WI 53045

Phone

(262) 782-0230

NPI assigned

Oct 1, 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. Jennifer Marie Larkin Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1191196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598400000000",
    "number": "1275720526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18740 W BLUEMOUND ROAD",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "53045",
            "telephone_number": "262-782-0230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18740 W BLUEMOUND ROAD",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "53045",
            "telephone_number": "262-782-0230"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1451 Cleveland Ave",
            "address_purpose": "LOCATION",
            "city": "Waukesha",
            "state": "WI",
            "postal_code": "531863876",
            "country_code": "US",
            "telephone_number": "262-547-2123",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COSTIGAN",
        "first_name": "JENNIFER",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-01",
        "last_updated": "2020-08-26",
        "certification_date": "2020-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "3283026",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40878700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "LARKIN",
            "middle_name": "MARIE",
            "prefix": "MS.",
            "credential": "OTR",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 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.