Individual provider Active NPI

Janelle A Niebeling, OTR/L

  • Occupational Therapist
  • Hudson, WI
National Provider Identifier
1285188037
Registry record updated Aug 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
4330-26 Issued in WI
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

Updated by the provider on Aug 10, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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 Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, WI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230925002552 MN Practitioner - Occupational Therapist in Private Practice 1254785249 Reassigns benefits to 1 organization
I20241210003142 WI Practitioner - Occupational Therapist in Private Practice 1254785249 Reassigns benefits to 1 organization

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
Tria Orthopaedic Center LLCGroup PAC ID 3173570561, 504 clinicians

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

LicenseStateTypeSpecialty
104796MNMDAnesthesiology Physician
4330-26WIMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Group Health, Inc. Current Accepting new patients
Group Health, Inc. CurrentSince Sep 18, 2023 Accepting new patients
Group Health, Inc. CurrentSince Sep 18, 2023 Accepting new patients
Tria Orthopaedic Center LLC CurrentSince Jan 1, 2025 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.

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.

Verify at the official NPI Registry.