Active NPI
Tara McPeak, MS, OTR
- Occupational Therapist
- Fremont, WI
National Provider Identifier
1366653248
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- Practice address
- N5509 36TH Dr
Fremont, WI 54940-8625 - Phone
- (920) 538-2210
- NPI assigned
- May 24, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | Primary |
Addresses
Primary practice location
N5509 36TH Dr
Fremont, WI 54940-8625
Mailing address
N5509 36TH Dr
Fremont, WI 54940-8625
Phone (920) 538-2210
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5709-26 | Medicaid | WI | |
| 1076273 | Other | WI | NBCOT |
Other names 1
- Tara McPeak
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
- Credentials
- Master of Science
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179964800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1494288000000",
"number": "1366653248",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "N5509 36TH DR",
"city": "FREMONT",
"state": "WI",
"postal_code": "549408625",
"telephone_number": "920-538-2210"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "N5509 36TH DR",
"city": "FREMONT",
"state": "WI",
"postal_code": "549408625",
"telephone_number": "920-538-2210"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCPEAK",
"first_name": "TARA",
"credential": "MS, OTR",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-24",
"last_updated": "2017-05-09",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5709-26",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NBCOT",
"identifier": "1076273",
"state": "WI"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "TARA",
"last_name": "MCPEAK",
"credential": "MS, OTR",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Fremont, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 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.