Individual provider Active NPI

Carina Lea Hafner, OT

  • Occupational Therapist
  • Weston, WI
National Provider Identifier
1407284417
Registry record updated Oct 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
5301-26 Issued in WI
Practice address
3301 Cranberry Blvd
Weston, WI 54476-5216
Phone
(715) 393-3990
Fax
(715) 393-3902
NPI assigned
Oct 30, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2013

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 5301-26 WI Primary

Addresses

Primary practice location

3301 Cranberry Blvd
Weston, WI 54476-5216

Mailing address

3301 Cranberry Blvd
Weston, WI 54476-5216
Phone (715) 393-3990

Other identifiers 1

IdentifierTypeStateIssuer
5301-26OtherWIWI STATE LICENSE

Other names 1

  • Ms. Carina Lea Hermann Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230906001205 WI Practitioner - Occupational Therapist in Private Practice 8426411604 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5301-26WIMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Langlade Hospital - Hotel Dieu of St Joseph of Antigo Wisconsin Current Accepting new patients
Aspirus Rhinelander & Tomahawk Hospitals & Clinics, Inc. CurrentSince May 20, 2025 Accepting new patients
Aspirus Rhinelander & Tomahawk Hospitals & Clinics, Inc. CurrentSince May 20, 2025 Accepting new patients
Aspirus Medical Group, Inc. CurrentSince Aug 27, 2023 Accepting new patients
Langlade Hospital - Hotel Dieu of St. Joseph of Antigo Wisconsin CurrentSince Aug 27, 2023 Accepting new patients
Langlade Memorial Hospital Past Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

112 E 5th Ave
Antigo, WI 54409
Phone (715) 623-2331

400 W Glen St
Crandon, WI 54520
Phone (715) 478-3318

2003 E Winnebago St
Rhinelander, WI 54501
Phone (715) 361-2300

2251 N Shore Dr
Ste 100
Rhinelander, WI 54501
Phone (715) 361-2074

401 W Mohawk Dr
Ste 100
Tomahawk, WI 54487
Phone (715) 453-7700

Organizations & group practices 6

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": "1383091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383091200000",
    "number": "1407284417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3301 CRANBERRY BLVD",
            "city": "WESTON",
            "state": "WI",
            "postal_code": "544765216",
            "telephone_number": "715-393-3990",
            "fax_number": "715-393-3902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3301 CRANBERRY BLVD",
            "city": "WESTON",
            "state": "WI",
            "postal_code": "544765216",
            "telephone_number": "715-393-3990",
            "fax_number": "715-393-3902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAFNER",
        "first_name": "CARINA",
        "middle_name": "LEA",
        "name_prefix": "Ms.",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-30",
        "last_updated": "2013-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "5301-26",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WI STATE LICENSE",
            "identifier": "5301-26",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARINA",
            "last_name": "HERMANN",
            "middle_name": "LEA",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Weston, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.