Mary Ann B Roelke, OTD, OTR

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

1127-26 Issued in WI

Practice address

1414 S Park St
Madison, WI 53715-2106

Phone

(608) 417-8250

NPI assigned

Dec 11, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710288000000",
    "number": "1447310552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 S PARK ST",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537151507",
            "telephone_number": "608-417-8250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 S PARK ST",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537152106",
            "telephone_number": "608-417-8250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROELKE",
        "first_name": "MARY ANN",
        "middle_name": "B",
        "credential": "OTD, OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-11",
        "last_updated": "2024-03-13",
        "certification_date": "2024-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "1127-26",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40713100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Bender Roe, NP
• Megan Mae Roedel, MD
• Cady Frances Roedl, DC
• Nicole Roehl
• Daniel Lawrence Roelke
• Eric Christian Roenning
• Lisa Ann Roessler, OTR
• David Roethe, PH.D.
• Judith Ann Roethe, MS CAPSW
• Lynn Ann Roethe, M.S., C.C.C.

• Occupational Therapist in Madison, WI
• Providers in Madison, WI by specialty
• Occupational Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2024; 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.