Individual provider Active NPI

Rose Mary Visser, OTR

  • Occupational Therapist
  • Milwaukee, WI
National Provider Identifier
1407227648
Registry record updated Oct 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
3647-26 Issued in WI
Practice address
912 N Hawley Rd
Milwaukee, WI 53213-3222
Phone
(414) 615-0115
Fax
(414) 256-8748
NPI assigned
Oct 14, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 3647-26 WI Primary

Addresses

Primary practice location

912 N Hawley Rd
Milwaukee, WI 53213-3222

Mailing address

912 N Hawley Rd
Milwaukee, WI 53213-3222
Phone (414) 615-0115

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151022002829 WI Practitioner - Occupational Therapist in Private Practice 3375852833 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vision Forward Association IncGroup PAC ID 4587631817, 4 clinicians

Practice addresses (Care Compare)

10150 W National Ave
Suite 100
West Allis, WI 53227-2160
Phone 4146150100121

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3647-26WIMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Vision Forward Association, Inc. CurrentSince Oct 14, 2015 Accepting new patients

Locations

912 N Hawley Rd
Milwaukee, WI 53213
Phone (414) 258-9200

10150 W National Ave
Ste 100
West Allis, WI 53227
Phone (414) 321-7520

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.

NPI Registry JSON

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

{
    "created_epoch": "1444780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444780800000",
    "number": "1407227648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "912 N HAWLEY RD",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532133222",
            "telephone_number": "414-615-0115",
            "fax_number": "414-256-8748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "912 N HAWLEY RD",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532133222",
            "telephone_number": "414-615-0115",
            "fax_number": "414-256-8748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VISSER",
        "first_name": "ROSE",
        "middle_name": "MARY",
        "name_prefix": "Mrs.",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-14",
        "last_updated": "2015-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "3647-26",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.