Active NPI
Joseph Wayne Konop, COTA
- Occupational Therapy Assistant
- Rib Lake, WI
National Provider Identifier
1447054200
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 5258-27
- Practice address
- 650 Pearl St
Rib Lake, WI 54470-9322 - Phone
- (715) 443-5921
- NPI assigned
- Apr 2, 2025
- Last updated
- Apr 2, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 5258-27 | WI | Primary |
Addresses
Primary practice location
650 Pearl St
Rib Lake, WI 54470-9322
Mailing address
508 E Conrad Dr
Medford, WI 54451-2037
Phone (507) 319-7894
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
| License | State | Type | Specialty |
|---|---|---|---|
| 5258-27 | WI | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1743552000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1743552000000",
"number": "1447054200",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "508 E CONRAD DR",
"city": "MEDFORD",
"state": "WI",
"postal_code": "544512037",
"telephone_number": "507-319-7894"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "650 PEARL ST",
"city": "RIB LAKE",
"state": "WI",
"postal_code": "544709322",
"telephone_number": "715-443-5921"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KONOP",
"first_name": "JOSEPH",
"middle_name": "WAYNE",
"credential": "COTA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-04-02",
"last_updated": "2025-04-02",
"certification_date": "2025-04-02",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "WI",
"license": "5258-27",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rib Lake, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 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.