Jack Ryan Speckman, OTR

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

8493 Issued in WI

Practice address

1000 Mineral Point Ave
Janesville, WI 53548-2940

Phone

(608) 756-6000

NPI assigned

Jan 30, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jspeckman110759@direct.mhemail.org

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.

• Mercy Health System Corporation

  • Multi-Specialty Clinic/Center
  • Janesville, WI
  • NPI 1598718603
  Medicare reassignment NPD
• Mercy Health System Corporation

  • General Acute Care Hospital
  • Janesville, WI
  • NPI 1093768962

  Occupational Therapist

  NPD
• Mercy Health System Corporation

  • Critical Access Hospital
  • Lake Geneva, WI
  • NPI 1699728550

  Occupational Therapist

  NPD
• Mercy Health System Corporation

  • Durable Medical Equipment & Medical Supplies
  • Beloit, WI
  • NPI 1619000437
  NPD (past)

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

{
    "created_epoch": "1706572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706832000000",
    "number": "1346003704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N151 COUNTY ROAD T",
            "city": "BRODHEAD",
            "state": "WI",
            "postal_code": "535209554",
            "telephone_number": "608-921-8668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 MINERAL POINT AVE",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "535482940",
            "telephone_number": "608-756-6000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2825 Prairie Ave",
            "address_purpose": "LOCATION",
            "city": "Beloit",
            "state": "WI",
            "postal_code": "535111844",
            "country_code": "US",
            "telephone_number": "608-363-5500",
            "fax_number": "608-363-5539",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3524 E Milwaukee St",
            "address_purpose": "LOCATION",
            "city": "Janesville",
            "state": "WI",
            "postal_code": "535461626",
            "country_code": "US",
            "telephone_number": "608-756-7100",
            "fax_number": "608-756-7225",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "557 N Washington St",
            "address_purpose": "LOCATION",
            "city": "Janesville",
            "state": "WI",
            "postal_code": "535482907",
            "country_code": "US",
            "telephone_number": "608-754-6000",
            "fax_number": "608-755-7892",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "N2950 State Road 67",
            "address_purpose": "LOCATION",
            "city": "Lake Geneva",
            "state": "WI",
            "postal_code": "531472655",
            "country_code": "US",
            "telephone_number": "262-245-0535",
            "fax_number": "262-245-2248",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SPECKMAN",
        "first_name": "JACK",
        "middle_name": "RYAN",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-01-30",
        "last_updated": "2024-02-02",
        "certification_date": "2024-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "8493",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jui-Han Solverson, NP-C
• Katherine Sommer, PHARMD
• Amy Sosa, PSY.D.
• Jessica Spaeth, PHARMD
• Holly Spaulding, LPC-T
• Baily Sperry
• Julie L Spooner, RN
• Haylie A Sprecher, OT
• Katie L Springer, LPC-IT
• Bethany Squier

• Occupational Therapist in Janesville, WI
• Providers in Janesville, WI by specialty
• Occupational Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.