Individual provider Active NPI

Emily Melissa Terry, OTR/L

  • Occupational Therapist
  • Lake Geneva, WI
National Provider Identifier
1306545298
Registry record updated Feb 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
8204-26 Issued in WI
Practice address
Hwys. 50 and 67
N2950 State Rd. 67
Lake Geneva, WI 53147
Phone
(262) 245-0535
NPI assigned
Feb 28, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 28, 2023

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 8204-26 WI Primary

Addresses

Primary practice location

Hwys. 50 and 67
N2950 State Rd. 67
Lake Geneva, WI 53147

Mailing address

61 Orchard St
Williams Bay, WI 53191-9708
Phone (262) 374-1849

Other names 1

  • Emily Melissa Dean Former name

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

State licenses

LicenseStateTypeSpecialty
8204-26WIMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health System Corporation Occupational Therapist Current Accepting new patients
Mercy Health System Corporation Occupational Therapist CurrentSince Mar 6, 2023 Accepting new patients
Mercy Health System Corporation CurrentSince Mar 6, 2023 Accepting new patients

Locations

29624 Network Pl
Chicago, IL 60673
Phone (608) 741-7652

1000 Mineral Point Ave
Janesville, WI 53548
Phone (608) 261-6868

N2950 State Road 67
Lake Geneva, WI 53147
Phone (262) 245-0535

Interoperability endpoints

  • Direct secure messaging: eterry100757@direct.mhemail.org

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1677542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677542400000",
    "number": "1306545298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61 ORCHARD ST",
            "city": "WILLIAMS BAY",
            "state": "WI",
            "postal_code": "531919708",
            "telephone_number": "262-374-1849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HWYS. 50 AND 67",
            "address_2": "N2950 STATE RD. 67",
            "city": "LAKE GENEVA",
            "state": "WI",
            "postal_code": "53147",
            "telephone_number": "262-245-0535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TERRY",
        "first_name": "EMILY",
        "middle_name": "MELISSA",
        "name_prefix": "Mrs.",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-02-28",
        "last_updated": "2023-02-28",
        "certification_date": "2023-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "8204-26",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EMILY",
            "last_name": "DEAN",
            "middle_name": "MELISSA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lake Geneva, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2023; 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.