Individual provider Active NPI

Jill Marie Wiley, OTA

  • Occupational Therapy Assistant
  • Arbor Vitae, WI
National Provider Identifier
1457429094
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
518-027 Issued in WI
Practice address
1256 Brandy Lake Rd
Arbor Vitae, WI 54568-0827
Phone
(715) 356-9729
Fax
(715) 358-5209
NPI assigned
Dec 1, 2006
Sex
Female
Sole proprietor
No

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
Occupational Therapy Assistant 224Z00000X 518-027 WI Primary

Addresses

Primary practice location

1256 Brandy Lake Rd
Arbor Vitae, WI 54568-0827

Mailing address

N12041 Breed Rd
Clintonville, WI 54929-9539
Phone (715) 823-3983

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

State licenses

LicenseStateTypeSpecialty
518-027WIMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Stratford Therapy Services, Inc. Past Accepting new patients
Jeanne H. Mather Occupational Therapy Assistant Past Accepting new patients

Organizations & group practices 2

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": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1457429094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N12041 BREED RD",
            "city": "CLINTONVILLE",
            "state": "WI",
            "postal_code": "549299539",
            "telephone_number": "715-823-3983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1256 BRANDY LAKE RD",
            "city": "ARBOR VITAE",
            "state": "WI",
            "postal_code": "545680827",
            "telephone_number": "715-356-9729",
            "fax_number": "715-358-5209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILEY",
        "first_name": "JILL",
        "middle_name": "MARIE",
        "credential": "OTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "WI",
            "license": "518-027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arbor Vitae, 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.