Individual provider Active NPI

Andrew James Warden, OTR/L

  • Occupational Therapist
  • Appleton, WI
National Provider Identifier
1487200523
Registry record updated Aug 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
6593-26 Issued in WI
Practice address
2323 N Casaloma Dr
Appleton, WI 54913-8284
Phone
(920) 730-8833
Fax
(920) 831-2968
NPI assigned
Aug 14, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2019

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 6593-26 WI Primary

Addresses

Primary practice location

2323 N Casaloma Dr
Appleton, WI 54913-8284

Mailing address

2323 N Casaloma Dr
Appleton, WI 54913-8284
Phone (920) 730-8833

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210505001614 WI Practitioner - Occupational Therapist in Private Practice 2769891654 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6593-26WIMDOccupational Therapist

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": "1565740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565740800000",
    "number": "1487200523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2323 N CASALOMA DR",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549138284",
            "telephone_number": "920-730-8833",
            "fax_number": "920-831-2968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2323 N CASALOMA DR",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549138284",
            "telephone_number": "920-730-8833",
            "fax_number": "920-831-2968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARDEN",
        "first_name": "ANDREW",
        "middle_name": "JAMES",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-14",
        "last_updated": "2019-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "6593-26",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Appleton, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.