Active NPI
Mary Ellen Julien, OTR
- Occupational Therapist
- Appleton, WI
National Provider Identifier
1447396429
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 2360
- Practice address
- 3305 N Ballard Rd Ste C
Appleton, WI 54911-9001 - Phone
- (920) 735-9234
- NPI assigned
- Jan 29, 2007
- Last updated
- Apr 23, 2008
- Sex
- Female
- 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 Therapist | 225X00000X | 2360 | WI | Primary |
Addresses
Primary practice location
3305 N Ballard Rd Ste C
Appleton, WI 54911-9001
Mailing address
N1350 Highgreen Dr
Greenville, WI 54942-9657
Phone (920) 757-9340
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 40758800 | Medicaid | WI |
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)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Valley-Bay Therapy Inc. | Occupational Therapist | 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": "1170028800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1208908800000",
"number": "1447396429",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "N1350 HIGHGREEN DR",
"city": "GREENVILLE",
"state": "WI",
"postal_code": "549429657",
"telephone_number": "920-757-9340"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3305 N BALLARD RD STE C",
"city": "APPLETON",
"state": "WI",
"postal_code": "549119001",
"telephone_number": "920-735-9234"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JULIEN",
"first_name": "MARY",
"middle_name": "ELLEN",
"credential": "OTR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-29",
"last_updated": "2008-04-23",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "WI",
"license": "2360",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "40758800",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Appleton, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.