Individual provider Active NPI

Nathaniel Marshall, OTD

  • Occupational Therapist
  • Pleasant Prairie, WI
National Provider Identifier
1447779319
Registry record updated Nov 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
7120 Issued in WI
Practice address
12500 Aurora Dr
Pleasant Prairie, WI 53158-1227
Phone
(262) 857-5800
NPI assigned
Sep 12, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 7120 WI Primary

Addresses

Primary practice location

12500 Aurora Dr
Pleasant Prairie, WI 53158-1227

Mailing address

PO Box 735044
Chicago, IL 60673-5044
Phone (800) 326-2250

Other practice location 1

444 S 44th St
Omaha, NE 68131-3727
Phone (402) 559-3563

Other identifiers 1

IdentifierTypeStateIssuer
100184087MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address nmarshall280250@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211115002133 WI Practitioner - Occupational Therapist in Private Practice 6002205986 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aurora Medical Group, Inc.Group PAC ID 6709794258, 3,764 clinicians

Practice addresses (Care Compare)

12500 Aurora Dr
Pleasant Prairie, WI 53158-1227
Phone (262) 857-5000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7120WIMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Medical Group, Inc. CurrentSince Oct 11, 2021 Accepting new patients
Aurora Advanced Healthcare, Inc. CurrentSince Oct 11, 2021 Accepting new patients
Lakeshore Medical Clinic, LLC CurrentSince Oct 11, 2021 Accepting new patients
Aurora Medical Group, Inc. Current Accepting new patients
Aurora Advanced Healthcare Inc CurrentSince Oct 11, 2021 Accepting new patients
Aurora Health Care Metro, Inc. CurrentSince Oct 11, 2021 Accepting new patients
Aurora Health Care Metro, Inc. CurrentSince Oct 11, 2021 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Oct 11, 2021 Accepting new patients
Aurora Medical Group, Inc. Past Accepting new patients

Locations

3003 W Good Hope Rd
Glendale, WI 53209
Phone (414) 352-3100

12203 N Corporate Pkwy
Mequon, WI 53092
Phone (262) 387-8200

2900 W Oklahoma Ave
Milwaukee, WI 53215
Phone (414) 385-2590

3301 W Forest Home Ave
Milwaukee, WI 53215
Phone (414) 389-2233

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

S74W16775 Janesville Rd
Muskego, WI 53150
Phone (414) 422-4747

12500 Aurora Dr
Pleasant Prairie, WI 53158
Phone (262) 857-5000

2000 E Layton Ave
St Francis, WI 53235
Phone (414) 744-7880

Interoperability endpoints

  • Direct secure messaging: nmarshall280250@direct.myadvocateaurora.org

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1505174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731801600000",
    "number": "1447779319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735044",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606735044",
            "telephone_number": "800-326-2250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12500 AURORA DR",
            "city": "PLEASANT PRAIRIE",
            "state": "WI",
            "postal_code": "531581227",
            "telephone_number": "262-857-5800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "444 S 44th St",
            "address_purpose": "LOCATION",
            "city": "Omaha",
            "state": "NE",
            "postal_code": "681313727",
            "country_code": "US",
            "telephone_number": "402-559-3563",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARSHALL",
        "first_name": "NATHANIEL",
        "credential": "OTD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-09-12",
        "last_updated": "2024-11-17",
        "certification_date": "2024-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "7120",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100184087",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nmarshall280250@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "12500 Aurora Dr",
            "city": "Pleasant Prairie",
            "state": "WI",
            "country_code": "US",
            "postal_code": "531581227",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "12500 Aurora Dr",
            "city": "Pleasant Prairie",
            "state": "WI",
            "country_code": "US",
            "postal_code": "531581227",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Pleasant Prairie, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.