Individual provider Active NPI

Mary Elizabeth Morris, OTR

  • Occupational Therapist
  • Pewaukee, WI
National Provider Identifier
1477872018
Registry record updated May 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
721-026 Issued in WI
Practice address
N22W27847 Edgewater Dr
Pewaukee, WI 53072-5260
Phone
(262) 264-0080
Fax
(262) 264-0081
NPI assigned
May 21, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2010

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 721-026 WI Primary

Addresses

Primary practice location

N22W27847 Edgewater Dr
Pewaukee, WI 53072-5260

Mailing address

N22W27847 Edgewater Dr
Pewaukee, WI 53072-5260
Phone (262) 264-0080

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

LicenseStateTypeSpecialty
721-026WIMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Evolution Exercise & Spine Center PastSince Nov 1, 2011 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.

NPI Registry JSON

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

{
    "created_epoch": "1274400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1274400000000",
    "number": "1477872018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N22W27847 EDGEWATER DR",
            "city": "PEWAUKEE",
            "state": "WI",
            "postal_code": "530725260",
            "telephone_number": "262-264-0080",
            "fax_number": "262-264-0081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N22W27847 EDGEWATER DR",
            "city": "PEWAUKEE",
            "state": "WI",
            "postal_code": "530725260",
            "telephone_number": "262-264-0080",
            "fax_number": "262-264-0081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORRIS",
        "first_name": "MARY",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-21",
        "last_updated": "2010-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "721-026",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pewaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2010; 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.