Individual provider Active NPI

Deborah Jean Hoover, OTR

  • Pediatric Occupational Therapist
  • Mosinee, WI
National Provider Identifier
1417008608
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
1700026 Issued in WI
Practice address
415 Orbiting Dr Ste B
Mosinee, WI 54455-1762
Phone
(715) 693-7178
Fax
(715) 693-7178
NPI assigned
Jan 15, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X 1700026 WI Primary

Addresses

Primary practice location

415 Orbiting Dr Ste B
Mosinee, WI 54455-1762

Mailing address

415 Orbiting Dr Ste B
Mosinee, WI 54455-1762
Phone (715) 693-7178

Other identifiers 1

IdentifierTypeStateIssuer
40825700MedicaidWI

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
1700026WIMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Therapy Specialists, LLC Pediatrics Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1168819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1417008608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 ORBITING DR STE B",
            "city": "MOSINEE",
            "state": "WI",
            "postal_code": "544551762",
            "telephone_number": "715-693-7178",
            "fax_number": "715-693-7178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 ORBITING DR STE B",
            "city": "MOSINEE",
            "state": "WI",
            "postal_code": "544551762",
            "telephone_number": "715-693-7178",
            "fax_number": "715-693-7178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOOVER",
        "first_name": "DEBORAH",
        "middle_name": "JEAN",
        "credential": "OTR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "WI",
            "license": "1700026",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40825700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mosinee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.