Active NPI
Mary P. Dimick, OT
- Occupational Therapist
- Menomonee Falls, WI
National Provider Identifier
1306079017
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 4428
- Practice address
- N84W16889 Menomonee Ave
Menomonee Falls, WI 53051-2810 - Phone
- (262) 251-7500
- Fax
- (262) 251-7128
- NPI assigned
- Aug 27, 2009
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 4428 | WI | Primary |
Addresses
Primary practice location
N84W16889 Menomonee Ave
Menomonee Falls, WI 53051-2810
Mailing address
3003 W Good Hope Rd
Milwaukee, WI 53209-2042
Phone (414) 352-3100
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00836840 | Other | WI | RR MEDICARE |
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1251331200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1283385600000",
"number": "1306079017",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3003 W GOOD HOPE RD",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532092042",
"telephone_number": "414-352-3100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "N84W16889 MENOMONEE AVE",
"city": "MENOMONEE FALLS",
"state": "WI",
"postal_code": "530512810",
"telephone_number": "262-251-7500",
"fax_number": "262-251-7128"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIMICK",
"first_name": "MARY",
"middle_name": "P.",
"credential": "OT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-08-27",
"last_updated": "2010-09-02",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "WI",
"license": "4428",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "P00836840",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Menomonee Falls, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.