Individual provider Active NPI

Amy Demaio

  • Occupational Therapy Assistant
  • Green Bay, WI
National Provider Identifier
1326574344
Registry record updated May 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
5365-27 Issued in WI
Practice address
1695 Crooks St
Green Bay, WI 54302-2853
Phone
(920) 639-3029
NPI assigned
May 11, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 5365-27 WI Primary

Addresses

Primary practice location

1695 Crooks St
Green Bay, WI 54302-2853

Mailing address

1695 Crooks St
Green Bay, WI 54302-2853

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

LicenseStateTypeSpecialty
5365-27WIMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1494460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494460800000",
    "number": "1326574344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1695 CROOKS ST",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543022853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1695 CROOKS ST",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543022853",
            "telephone_number": "920-639-3029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMAIO",
        "first_name": "AMY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-11",
        "last_updated": "2017-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "WI",
            "license": "5365-27",
            "primary": true
        }
    ],
    "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 May 11, 2017; 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.