Active NPI
Janelle A Niebeling, OTR/L
- Occupational Therapist
- Hudson, WI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 4330-26
- Practice address
- 411 Stageline Rd
Hudson, WI 54016-7848 - Phone
- (715) 531-6000
- NPI assigned
- Aug 10, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 4330-26 | WI | Primary |
| Occupational Therapist | 225X00000X | 104796 | MN |
Addresses
Primary practice location
411 Stageline Rd
Hudson, WI 54016-7848
Mailing address
220 Jefferson St
River Falls, WI 54022-3111
Phone (715) 426-5189
Other names 1
- Miss Janelle A Wallace
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN, WI
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Occupational Therapist in Private Practice
- Education
- Other, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
403 Stageline Rd
Hudson, WI 54016-7848
Phone (952) 831-8742
405 Stageline Rd
Hudson, WI 54016-7848
Phone (952) 831-8742
411 Stageline Rd
Hudson, WI 54016-7848
Phone (952) 831-8742
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 104796 | MN | MD | Anesthesiology Physician |
| 4330-26 | WI | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Group Health, Inc. | Current | Accepting new patients | |
| Group Health, Inc. | Current | Accepting new patients | |
| Group Health, Inc. | Current | Accepting new patients | |
| Tria Orthopaedic Center LLC | Current | Accepting new patients |
Locations
8170 33rd Ave S
#21110Q
Minneapolis, MN 55425
Phone (952) 883-5375
8600 Nicollet Ave S
Minneapolis, MN 55420
Phone (952) 887-6600
8170 33rd Ave S
Minneapolis, MN 55425
Phone (952) 883-5463
405 Stageline Rd
Hudson, WI 54016
Phone (715) 531-6000
411 Stageline Rd
Hudson, WI 54016
Phone (715) 531-6000
Organizations & group practices 4
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.
-
- Multi-Specialty Clinic/Center
- Minneapolis, MN
- NPI 1710924683
-
- Pediatric Dentistry
- Minneapolis, MN
- NPI 1700932449
-
- General Practice Dentistry
- Saint Paul, MN
- NPI 1952042053
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1470787200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1470787200000",
"number": "1285188037",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "220 JEFFERSON ST",
"city": "RIVER FALLS",
"state": "WI",
"postal_code": "540223111",
"telephone_number": "715-426-5189"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "411 STAGELINE RD",
"city": "HUDSON",
"state": "WI",
"postal_code": "540167848",
"telephone_number": "715-531-6000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NIEBELING",
"first_name": "JANELLE",
"middle_name": "A",
"name_prefix": "Mrs.",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-08-10",
"last_updated": "2016-08-10",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "WI",
"license": "4330-26",
"primary": true
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MN",
"license": "104796",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JANELLE",
"last_name": "WALLACE",
"middle_name": "A",
"prefix": "MISS",
"credential": "OTR/L",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Hudson, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.