Active NPI
Sue Ann Vollmer, OTR
- Occupational Therapist
- New Holstein, WI
National Provider Identifier
1508078312
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 3392-026
- Practice address
- 1610 Hoover St
New Holstein, WI 53061-1636 - Phone
- (920) 898-5627
- Fax
- (920) 898-1375
- NPI assigned
- May 4, 2007
- 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 Therapist | 225X00000X | 3392-026 | WI | Primary |
Addresses
Primary practice location
1610 Hoover St
New Holstein, WI 53061-1636
Mailing address
N8011 Fairfield Dr
Fond Du Lac, WI 54935-7813
Phone (920) 923-1192
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 41037500 | Medicaid | WI |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3392-026 | WI | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178236800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1508078312",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "N8011 FAIRFIELD DR",
"city": "FOND DU LAC",
"state": "WI",
"postal_code": "549357813",
"telephone_number": "920-923-1192"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1610 HOOVER ST",
"city": "NEW HOLSTEIN",
"state": "WI",
"postal_code": "530611636",
"telephone_number": "920-898-5627",
"fax_number": "920-898-1375"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VOLLMER",
"first_name": "SUE",
"middle_name": "ANN",
"name_prefix": "Mrs.",
"credential": "OTR",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-04",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "WI",
"license": "3392-026",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "41037500",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in New Holstein, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.