Individual provider Active NPI

Bobbi-Jo Rivera, MS, OTR/L

  • Occupational Therapist
  • La Crosse, WI
National Provider Identifier
1346563806
Registry record updated Nov 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
4857-026 Issued in WI
Practice address
The Parenting Place
1500 Green Bay Street
La Crosse, WI 54601-6455
Phone
(608) 784-8125
Fax
(608) 796-0098
NPI assigned
Mar 11, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2020

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 103980 MN
Occupational Therapist 225X00000X 4857-026 WI Primary

Addresses

Primary practice location

The Parenting Place
1500 Green Bay Street
La Crosse, WI 54601-6455

Mailing address

The Parenting Place
1500 Green Bay Street
La Crosse, WI 54601-6455
Phone (608) 784-8125

Other identifiers 2

IdentifierTypeStateIssuer
ENROLLEDMedicaidIA
ENROLLEDMedicaidMN

Other names 1

  • Bobbi-Jo Crank Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100721000005 WI Practitioner - Occupational Therapist in Private Practice 1658403035 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
4857WIMDPhysical Therapist
4857-026WIMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Gundersen Clinic LTD Current Accepting new patients
Gundersen Lutheran Express Care, Inc CurrentSince May 23, 2023 Accepting new patients
Gundersen Clinic, LTD. CurrentSince May 23, 2023 Accepting new patients
Gundersen Clinic, LTD. Past Accepting new patients

Locations

402 W Lake St
Friendship, WI 53934
Phone (608) 339-3331

1836 South Ave
La Crosse, WI 54601
Phone (608) 788-8102

1111 W Wisconsin St
Sparta, WI 54656
Phone (608) 263-9531

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1268265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605052800000",
    "number": "1346563806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "THE PARENTING PLACE",
            "address_2": "1500 GREEN BAY STREET",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546016455",
            "telephone_number": "608-784-8125",
            "fax_number": "608-796-0098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "THE PARENTING PLACE",
            "address_2": "1500 GREEN BAY STREET",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546016455",
            "telephone_number": "608-784-8125",
            "fax_number": "608-796-0098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "BOBBI-JO",
        "credential": "MS, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-11",
        "last_updated": "2020-11-11",
        "certification_date": "2020-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MN",
            "license": "103980",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "4857-026",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ENROLLED",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ENROLLED",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BOBBI-JO",
            "last_name": "CRANK",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in La Crosse, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2020; 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.