Individual provider Active NPI

Amy Theresa Rebro, COTA

  • Occupational Therapy Assistant
  • Milwaukee, WI
National Provider Identifier
1407665094
Registry record updated Jan 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
7205-27 Issued in WI
Practice address
6263 N Green Bay Ave
Milwaukee, WI 53209-3823
Phone
(414) 351-0543
NPI assigned
Jan 7, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2025

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 7205-27 WI Primary

Addresses

Primary practice location

6263 N Green Bay Ave
Milwaukee, WI 53209-3823

Mailing address

601 S Oak Park CT
Milwaukee, WI 53214-1929
Phone (414) 322-6716

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
7205-27WIMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1736208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736208000000",
    "number": "1407665094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 S OAK PARK CT",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532141929",
            "telephone_number": "414-322-6716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6263 N GREEN BAY AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532093823",
            "telephone_number": "414-351-0543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REBRO",
        "first_name": "AMY",
        "middle_name": "THERESA",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-07",
        "last_updated": "2025-01-07",
        "certification_date": "2025-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "WI",
            "license": "7205-27",
            "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 Jan 7, 2025; 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.