Individual provider Active NPI

Joy R Laga, OTR

  • Occupational Therapist
  • Green Bay, WI
National Provider Identifier
1295993566
Registry record updated May 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
3154026 Issued in WI
Practice address
1660 Hoffman Rd
Green Bay, WI 54311-6299
Phone
(920) 337-0771
NPI assigned
May 23, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 8, 2024

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 3154026 WI Primary

Addresses

Primary practice location

1660 Hoffman Rd
Green Bay, WI 54311-6299

Mailing address

513 Susan St
Combined Locks, WI 54113-1319
Phone (920) 470-1282

Other identifiers 1

IdentifierTypeStateIssuer
40845200MedicaidWI

Other names 1

  • Joy R Nienhaus Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240404003546 WI Practitioner - Occupational Therapist in Private Practice 4486092731 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3154026WIMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Phyt Rehab of Wisconsin, Inc. CurrentSince May 1, 2024 Accepting new patients
Sundance Rehabilitation LLC CurrentSince Mar 1, 2024 Accepting new patients

Locations

171 Kings Hwy
Brooklyn, NY 11223
Phone (877) 722-7700

6109 Braun Rd
Mount Pleasant, WI 53403
Phone (262) 484-4724

911 Jackson St
Ste 101
Wausau, WI 54403
Phone (914) 837-6538

Organizations & group practices 2

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": "1211500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715126400000",
    "number": "1295993566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "513 SUSAN ST",
            "city": "COMBINED LOCKS",
            "state": "WI",
            "postal_code": "541131319",
            "telephone_number": "920-470-1282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1660 HOFFMAN RD",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543116299",
            "telephone_number": "920-337-0771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAGA",
        "first_name": "JOY",
        "middle_name": "R",
        "credential": "OTR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-23",
        "last_updated": "2024-05-08",
        "certification_date": "2024-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "3154026",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40845200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOY",
            "last_name": "NIENHAUS",
            "middle_name": "R",
            "credential": "OTR",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Green Bay, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2024; 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.