Individual provider Active NPI

Heather D Wuolle, COTA

  • Occupational Therapy Assistant
  • Viroqua, WI
National Provider Identifier
1376520072
Registry record updated Dec 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
1681 Issued in WI
Practice address
507 S Main St
Vernon Memorial Healthcare
Viroqua, WI 54665-2059
Phone
(608) 637-2101
Fax
(608) 637-4382
NPI assigned
Dec 23, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2014

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 1681 WI Primary

Addresses

Primary practice location

507 S Main St
Vernon Memorial Healthcare
Viroqua, WI 54665-2059

Mailing address

507 S Main St
Vernon Memorial Healthcare
Viroqua, WI 54665-2059
Phone (608) 637-2101

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
1681WIMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1135296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1419206400000",
    "number": "1376520072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "507 S MAIN ST",
            "address_2": "VERNON MEMORIAL HEALTHCARE",
            "city": "VIROQUA",
            "state": "WI",
            "postal_code": "546652059",
            "telephone_number": "608-637-2101",
            "fax_number": "608-637-4382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "507 S MAIN ST",
            "address_2": "VERNON MEMORIAL HEALTHCARE",
            "city": "VIROQUA",
            "state": "WI",
            "postal_code": "546652059",
            "telephone_number": "608-637-2101",
            "fax_number": "608-637-4382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WUOLLE",
        "first_name": "HEATHER",
        "middle_name": "D",
        "name_prefix": "Ms.",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-23",
        "last_updated": "2014-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "WI",
            "license": "1681",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Viroqua, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2014; 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.