Active NPI
Deborah Rock, COTA
- Occupational Therapy Assistant
- Ashladn, WI
National Provider Identifier
1548434145
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 1112-027
- Practice address
- 1635 Maple Lane
Behavioral Health Services
Ashladn, WI 54806 - Phone
- (715) 685-5400
- Fax
- (715) 685-5102
- NPI assigned
- Apr 15, 2008
- Last updated
- Apr 15, 2008
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 1112-027 | WI | Primary |
Addresses
Primary practice location
1635 Maple Lane
Behavioral Health Services
Ashladn, WI 54806
Mailing address
1635 Maple Lane
Behavioral Health Services
Ashladn, WI 54806
Phone (715) 685-5400
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 40889400 | 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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1112-027 | WI | MD | Occupational Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Memorial Medical Center Inc | Past | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Tamarack Health Ashland Clinic
- Rural Health Clinic/Center
- Ashland, WI
- NPI 1770255937
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1208217600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1208217600000",
"number": "1548434145",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1635 MAPLE LANE",
"address_2": "BEHAVIORAL HEALTH SERVICES",
"city": "ASHLADN",
"state": "WI",
"postal_code": "54806",
"telephone_number": "715-685-5400",
"fax_number": "715-685-5102"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1635 MAPLE LANE",
"address_2": "BEHAVIORAL HEALTH SERVICES",
"city": "ASHLADN",
"state": "WI",
"postal_code": "54806",
"telephone_number": "715-685-5400",
"fax_number": "715-685-5102"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROCK",
"first_name": "DEBORAH",
"credential": "COTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-04-15",
"last_updated": "2008-04-15",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "WI",
"license": "1112-027",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "40889400",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.