Individual provider Active NPI

Dalton Lardinois

  • Occupational Therapist
  • Green Bay, WI
National Provider Identifier
1316896707
Registry record updated Jan 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
9088-26 Issued in WI
Practice address
617 S Roosevelt St
Green Bay, WI 54301-3402
Phone
(920) 433-7822
NPI assigned
Jan 27, 2026
Last updated
Jan 29, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 9088-26 WI Primary
Physical Rehabilitation Occupational Therapist 225XP0019X NU

Addresses

Primary practice location

617 S Roosevelt St
Green Bay, WI 54301-3402

Mailing address

617 S Roosevelt St
Green Bay, WI 54301-3402

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260210002939 WI Practitioner - Occupational Therapist in Private Practice 5193204030 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

744 S Webster Ave
Green Bay, WI 54301-3505

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9088-26WIMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Bellin Memorial Hospital Inc Occupational Therapist CurrentSince Jan 26, 2026 Accepting new patients
Oconto Hospital & Medical Center Inc CurrentSince Jan 26, 2026 Accepting new patients
Bellin Memorial Hospital Inc CurrentSince Jan 26, 2026 Accepting new patients
Oconto Hospital & Medical Center Inc CurrentSince Jan 26, 2026 Accepting new patients

Locations

617 S Roosevelt St
Green Bay, WI 54301
Phone (920) 432-5434

744 S Webster Ave
Green Bay, WI 54301
Phone (920) 433-6025

2820 Roosevelt Rd
Marinette, WI 54143
Phone (715) 330-6171

820 Arbutus Ave
Oconto, WI 54153
Phone (920) 835-1100

Organizations & group practices 5

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": "1769472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769644800000",
    "number": "1316896707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "617 S ROOSEVELT ST",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543013402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "617 S ROOSEVELT ST",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543013402",
            "telephone_number": "920-433-7822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARDINOIS",
        "first_name": "DALTON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-01-27",
        "last_updated": "2026-01-29",
        "certification_date": "2026-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "9088-26",
            "primary": true
        },
        {
            "code": "225XP0019X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Physical Rehabilitation",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jan 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.