Individual provider Active NPI

Heather Berglund, OTR

  • Occupational Therapist
  • Kenosha, WI
National Provider Identifier
1295039311
Registry record updated Jan 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
4884-026 Issued in WI
Practice address
1519 60TH St
Kenosha, WI 53140-3954
Phone
(262) 656-7500
NPI assigned
Jan 4, 2011
Last updated
Jan 18, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 18, 2013

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 4884-026 WI Primary

Addresses

Primary practice location

1519 60TH St
Kenosha, WI 53140-3954

Mailing address

8551 Ventana Dr Unit 4423
Oak Creek, WI 53154-8342
Phone (701) 650-0226

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250312003098 MN Practitioner - Occupational Therapist in Private Practice 0244751774 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4884-026WIMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Optage Inc Occupational Therapist CurrentSince Apr 1, 2025 Accepting new patients
Optage Inc Occupational Therapist CurrentSince Apr 1, 2025 Accepting new patients
Optage Inc Occupational Therapist Current Accepting new patients

Locations

2845 Hamline Ave N
Saint Paul, MN 55113
Phone (651) 631-6100

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1294099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358467200000",
    "number": "1295039311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8551 VENTANA DR UNIT 4423",
            "city": "OAK CREEK",
            "state": "WI",
            "postal_code": "531548342",
            "telephone_number": "701-650-0226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1519 60TH ST",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531403954",
            "telephone_number": "262-656-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGLUND",
        "first_name": "HEATHER",
        "name_prefix": "Mrs.",
        "credential": "OTR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-01-04",
        "last_updated": "2013-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "4884-026",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kenosha, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.