Active NPI
Betsy A Johnson, OTR
- Occupational Therapist
- Mount Horeb, WI
National Provider Identifier
1316130479
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 3136-026
- Practice address
- 407 N 8TH St
Mount Horeb, WI 53572-1872 - Phone
- (608) 437-9626
- NPI assigned
- Aug 22, 2007
- 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 | 3136-026 | WI | Primary |
Addresses
Primary practice location
407 N 8TH St
Mount Horeb, WI 53572-1872
Mailing address
407 N 8TH St
Mount Horeb, WI 53572-1872
Phone (608) 437-9626
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 40904600 | Medicaid | WI |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 3136-026 | WI | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1187740800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1370476800000",
"number": "1316130479",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "407 N 8TH ST",
"city": "MOUNT HOREB",
"state": "WI",
"postal_code": "535721872",
"telephone_number": "608-437-9626"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "407 N 8TH ST",
"city": "MOUNT HOREB",
"state": "WI",
"postal_code": "535721872",
"telephone_number": "608-437-9626"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "BETSY",
"middle_name": "A",
"credential": "OTR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-08-22",
"last_updated": "2013-06-06",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "WI",
"license": "3136-026",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "40904600",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mount Horeb, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.