Active NPI
Carissa A Sommer, OTR/L
- Occupational Therapist
- Sheboygan, WI
National Provider Identifier
1497319941
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 6492
- Practice address
- 2414 Kohler Memorial Dr
Sheboygan, WI 53081-3129 - Phone
- (920) 457-4461
- NPI assigned
- Apr 30, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Occupational Therapist | 225XP0200X | 6492-26 | WI | |
| Occupational Therapist | 225X00000X | 6492 | WI | Primary |
Addresses
Primary practice location
2414 Kohler Memorial Dr
Sheboygan, WI 53081-3129
Mailing address
PO Box 735044
Chicago, IL 60673-5044
Phone (920) 457-4461
Other practice location 1
620 Schoenhaar Dr
West Bend, WI 53090-2649
Phone (262) 306-8450
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6492-26 | Other | WI OTR/L LICENSE NUMBER | |
| 100102629 | Medicaid | WI |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | csommer369940@direct.myadvocateaurora.org | Direct | |
| FHIR URL | https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6492-26 | WI | MD | Pediatric Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aurora Medical Group, Inc. | Current | Accepting new patients | |
| Aurora Medical Group, Inc. | Current | Accepting new patients | |
| Aurora Medical Group, Inc. | Current | Accepting new patients | |
| Aurora Medical Group, Inc. | Past | Accepting new patients |
Locations
1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056
2414 Kohler Memorial Dr
Sheboygan, WI 53081
Phone (920) 457-4461
Organizations & group practices 4
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.
-
- Certified Registered Nurse Anesthetist
- Milwaukee, WI
- NPI 1427271378
-
- Durable Medical Equipment & Medical Supplies
- Oshkosh, WI
- NPI 1326858044
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Milwaukee, WI
- NPI 1659599157
-
- Durable Medical Equipment & Medical Supplies
- Manitowoc, WI
- NPI 1801941075
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1556582400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1690243200000",
"number": "1497319941",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 735044",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606735044",
"telephone_number": "920-457-4461"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2414 KOHLER MEMORIAL DR",
"city": "SHEBOYGAN",
"state": "WI",
"postal_code": "530813129",
"telephone_number": "920-457-4461"
}
],
"practiceLocations": [
{
"address_1": "620 Schoenhaar Dr",
"address_purpose": "LOCATION",
"city": "West Bend",
"state": "WI",
"postal_code": "530902649",
"country_code": "US",
"telephone_number": "262-306-8450",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SOMMER",
"first_name": "CARISSA",
"middle_name": "A",
"name_prefix": "Mrs.",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-04-30",
"last_updated": "2023-07-25",
"certification_date": "2023-07-25",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "WI",
"license": "6492-26",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "WI",
"license": "6492",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WI OTR/L LICENSE NUMBER",
"identifier": "6492-26",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100102629",
"state": "WI"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "csommer369940@direct.myadvocateaurora.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "2414 Kohler Memorial Dr",
"city": "Sheboygan",
"state": "WI",
"country_code": "US",
"postal_code": "530813129",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
"affiliation": "N",
"address_1": "2414 Kohler Memorial Dr",
"city": "Sheboygan",
"state": "WI",
"country_code": "US",
"postal_code": "530813129",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Sheboygan, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2023; 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.