Gwendolyn Hermes
Individual provider Active NPI Occupational Therapist · Juneau, WI
NPI 1487809182 · NPPES record last updated Nov 21, 2008
Key facts
- NPI
- 1487809182
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapist 225X00000X
- License
- 4620-026 (WI)
- Practice address
- 199 Home Rd
Juneau, WI 53039-1401 - Phone
- (920) 386-3539
- NPI assigned
- Nov 21, 2008
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 24
Medicare Care Compare profile
- Specialty
- Occupational Therapist in Private Practice
- Education
- Other, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Healthpro Heritage Rehab and Fitness LLC
Practice addresses (Care Compare)
199 County DF
Juneau, WI 53039-9512
Phone (920) 245-5116
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20101108001263 | WI | Practitioner - Occupational Therapist in Private Practice | 8224223961 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4620-026 | WI | MD | Occupational Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 4620-026 | WI | Yes |
Addresses
Primary practice location
199 Home Rd
Juneau, WI 53039-1401
Mailing address
108 We Go TRL
Fox Lake, WI 53933-9620
Phone (920) 928-6436
Other providers in Juneau, WI
- Rachel Leigh Goss
- Robert Wayne Griesel
- Greg L Hanson
- Healing Relationships LLC
- Kim M Herman
- McKenzie Cathrine Hintz
- Emily Ann Johnson
- Emily Jorgensen
- Melissa Rose Josie
- Juneau Chiropractic Center
All providers in Juneau, WI · Occupational Therapist in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 21, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.