Individual provider Active NPI

Nancie A Heneghan, OTR

  • Occupational Therapist
  • Cedarburg, WI
National Provider Identifier
1285856476
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
2138-026 Issued in WI
Practice address
N27W5707 Lincoln Blvd
Cedarburg, WI 53012-2852
Phone
(262) 376-7676
NPI assigned
May 3, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 2138-026 WI Primary

Addresses

Primary practice location

N27W5707 Lincoln Blvd
Cedarburg, WI 53012-2852

Mailing address

7343 Glencoe Dr
Cedarburg, WI 53012-8837
Phone (262) 375-0598

Other identifiers 1

IdentifierTypeStateIssuer
40867000MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2138-026WIMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1285856476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7343 GLENCOE DR",
            "city": "CEDARBURG",
            "state": "WI",
            "postal_code": "530128837",
            "telephone_number": "262-375-0598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N27W5707 LINCOLN BLVD",
            "city": "CEDARBURG",
            "state": "WI",
            "postal_code": "530122852",
            "telephone_number": "262-376-7676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENEGHAN",
        "first_name": "NANCIE",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "OTR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "2138-026",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40867000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedarburg, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.