Active NPI
Barbara Marie Van Lieshout, MOTR, ATP
- Other Specialist/Technologist
- Jefferson, WI
National Provider Identifier
1386775906
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Other Specialist/Technologist
- License
- 124-027
- Practice address
- 229 Meadow CT
Jefferson, WI 53549-1184 - Phone
- (920) 674-6339
- Fax
- (920) 674-6345
- NPI assigned
- Mar 7, 2007
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Other Specialist/Technologist | 246Z00000X | 124-027 | WI | Primary |
Addresses
Primary practice location
229 Meadow CT
Jefferson, WI 53549-1184
Mailing address
229 Meadow CT
Jefferson, WI 53549-1184
Phone (920) 674-6069
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 124-027 | WI | MD | Other Specialist/Technologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jefferson County | Past | Accepting new patients | |
| Innovative Rehab Consultants, Inc. | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Occupational Therapist
- Jefferson, WI
- NPI 1033444377
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Jefferson, WI
- NPI 1578562286
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173225600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1254700800000",
"number": "1386775906",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "229 MEADOW CT",
"city": "JEFFERSON",
"state": "WI",
"postal_code": "535491184",
"telephone_number": "920-674-6069"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "229 MEADOW CT",
"city": "JEFFERSON",
"state": "WI",
"postal_code": "535491184",
"telephone_number": "920-674-6339",
"fax_number": "920-674-6345"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VAN LIESHOUT",
"first_name": "BARBARA",
"middle_name": "MARIE",
"name_prefix": "Mrs.",
"credential": "MOTR, ATP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-07",
"last_updated": "2009-10-05",
"status": "A"
},
"taxonomies": [
{
"code": "246Z00000X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Other",
"state": "WI",
"license": "124-027",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Jefferson, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.