Active NPI
Debra Irene Erwin
- Occupational Therapy Assistant
- Frederic, WI
National Provider Identifier
1477858017
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 779-27
- Practice address
- 205 United Way
Frederic, WI 54837-8938 - Phone
- (715) 986-2019
- NPI assigned
- Jan 12, 2011
- Sex
- Female
- Sole proprietor
- Yes
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 Therapy Assistant | 224Z00000X | 779-27 | WI | Primary |
Addresses
Primary practice location
205 United Way
Frederic, WI 54837-8938
Mailing address
1549 1 1/2 2ND St
Turtle Lake, WI 54889-9700
Phone (715) 986-2019
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 779-27 | WI | MD | Occupational Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| NSH Cornell LLC | 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 and National Provider Directory roles.
-
- Skilled Nursing Facility
- Cornell, WI
- NPI 1417475245
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1294790400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1294790400000",
"number": "1477858017",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1549 1 1/2 2ND ST",
"city": "TURTLE LAKE",
"state": "WI",
"postal_code": "548899700",
"telephone_number": "715-986-2019"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "205 UNITED WAY",
"city": "FREDERIC",
"state": "WI",
"postal_code": "548378938",
"telephone_number": "715-986-2019"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ERWIN",
"first_name": "DEBRA",
"middle_name": "IRENE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-01-12",
"last_updated": "2011-01-12",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "WI",
"license": "779-27",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Frederic, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.