Individual provider Active NPI

Jennifer Lee Rau Nelson, COTA

  • Occupational Therapy Assistant
  • Appleton, WI
National Provider Identifier
1346407004
Registry record updated Apr 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
1127027 Issued in WI
Practice address
1335 S Oneida St
Appleton, WI 54915-1351
Phone
(920) 731-6646
NPI assigned
May 20, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2025

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 1127027 WI Primary

Addresses

Primary practice location

1335 S Oneida St
Appleton, WI 54915-1351

Mailing address

243 Kaukauna St
Apt B.
Menasha, WI 54952-3021
Phone (920) 731-6646

Other identifiers 1

IdentifierTypeStateIssuer
41038100MedicaidWI

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
1127027WIMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1211241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743724800000",
    "number": "1346407004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "243 KAUKAUNA ST",
            "address_2": "APT B.",
            "city": "MENASHA",
            "state": "WI",
            "postal_code": "549523021",
            "telephone_number": "920-731-6646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1335 S ONEIDA ST",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549151351",
            "telephone_number": "920-731-6646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAU NELSON",
        "first_name": "JENNIFER",
        "middle_name": "LEE",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-20",
        "last_updated": "2025-04-04",
        "certification_date": "2025-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "WI",
            "license": "1127027",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41038100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Appleton, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2025; 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.