Sara Lynn Wilde, OTR

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

Practice address

1504 Madison Ave
Fort Atkinson, WI 53538-3100

Phone

(920) 563-9357

Fax

(920) 568-6545

NPI assigned

Jul 31, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Mrs. Sara Lynn Schultz Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1185840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449446400000",
    "number": "1396935847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1504 MADISON AVE",
            "city": "FORT ATKINSON",
            "state": "WI",
            "postal_code": "535383100",
            "telephone_number": "920-563-9357",
            "fax_number": "920-568-6545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1504 MADISON AVE",
            "city": "FORT ATKINSON",
            "state": "WI",
            "postal_code": "535383100",
            "telephone_number": "920-563-9357",
            "fax_number": "920-568-6545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILDE",
        "first_name": "SARA",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-31",
        "last_updated": "2015-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "4510-026",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41046300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SARA",
            "last_name": "SCHULTZ",
            "middle_name": "LYNN",
            "prefix": "MRS.",
            "credential": "OTR",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Annette Marie Weirick, LPTA
• Laurie Jean Welch, RN
• Heather Lee Wellnitz
• Herbert Turner Wentzien, LPC
• Bailey Jane Whiting, PT, DPT
• Tracy Paul Wilde, PT
• Trisha Williams Obiweluozor, RN
• Wilson Chiropractic & Wellness LLC
• Brett Wilson, DO
• Stephanie Tronnes Wilson, D.C.

• Occupational Therapist in Fort Atkinson, WI
• Providers in Fort Atkinson, WI by specialty
• Occupational Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2015; 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.