Individual provider Active NPI

Dawn A Malaj, OTR

  • Occupational Therapist
  • West Bend, WI
National Provider Identifier
1457525420
Registry record updated Feb 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
4386-026 Issued in WI
Practice address
531 E Washington St
West Bend, WI 53095-2531
Phone
(262) 335-4532
NPI assigned
Apr 21, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 9, 2017

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 4386-026 WI Primary

Addresses

Primary practice location

531 E Washington St
West Bend, WI 53095-2531

Mailing address

348 E Ryan Rd
Oak Creek, WI 53154-4535
Phone (414) 899-8005

Other identifiers 1

IdentifierTypeStateIssuer
40900000MedicaidWI

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
4386-026WIMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1208736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486598400000",
    "number": "1457525420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "348 E RYAN RD",
            "city": "OAK CREEK",
            "state": "WI",
            "postal_code": "531544535",
            "telephone_number": "414-899-8005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "531 E WASHINGTON ST",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "530952531",
            "telephone_number": "262-335-4532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALAJ",
        "first_name": "DAWN",
        "middle_name": "A",
        "credential": "OTR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-21",
        "last_updated": "2017-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "4386-026",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40900000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Bend, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2017; 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.