Brent Alan Nordquist, COTA

Individual provider Active NPI Occupational Therapy Assistant · Hammond, WI

NPI 1356972137 · NPPES record last updated Jan 30, 2020

Key facts

NPI
1356972137
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
License
5620-27 (WI)
Practice address
425 Davis St
Hammond, WI 54015-9615
Phone
(715) 688-9174
NPI assigned
Jan 30, 2020
Sex
Male
Sole proprietor
No

Organizations & group practices 1

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
5620-27WIMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
NSH Hammond LLC Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 5620-27 WI Yes

Addresses

Primary practice location

425 Davis St
Hammond, WI 54015-9615

Mailing address

425 Davis St
Hammond, WI 54015-9615

Electronic endpoints

TypeEndpointUseAffiliation
Direct Messaging Address bnordquist@adaptiverehab.com Direct

Other providers in Hammond, WI

All providers in Hammond, WI · Occupational Therapy Assistant in Wisconsin

Sources for this page

Verify at the official NPI Registry.