Active NPI
Heidi Stubb, OTR/L
- Pediatric Occupational Therapist
- Green Bay, WI
National Provider Identifier
1548466741
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Occupational Therapist
- License
- 1975026
- Practice address
- 835 S Van Buren St
Green Bay, WI 54301-3526 - Phone
- (920) 433-8182
- NPI assigned
- Jun 25, 2007
- 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 |
|---|---|---|---|---|
| Pediatric Occupational Therapist | 225XP0200X | 1975026 | WI | Primary |
Addresses
Primary practice location
835 S Van Buren St
Green Bay, WI 54301-3526
Mailing address
835 S Van Buren St
Green Bay, WI 54301-3526
Phone (920) 433-8182
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 41810300 | Medicaid | WI |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | hstubb17488@ewd.direct.hshs.org | Direct |
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 |
|---|---|---|---|
| 1975026 | WI | MD | Pediatric Occupational Therapist |
Interoperability endpoints
- hstubb17488@ewd.direct.hshs.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1182729600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1640822400000",
"number": "1548466741",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "835 S VAN BUREN ST",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "543013526",
"telephone_number": "920-433-8182"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "835 S VAN BUREN ST",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "543013526",
"telephone_number": "920-433-8182"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STUBB",
"first_name": "HEIDI",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-06-25",
"last_updated": "2021-12-30",
"certification_date": "2021-12-30",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "WI",
"license": "1975026",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "41810300",
"state": "WI"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "hstubb17488@ewd.direct.hshs.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "CDA/CCD/TXT",
"address_1": "835 S Van Buren St",
"city": "Green Bay",
"state": "WI",
"country_code": "US",
"postal_code": "543013526",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Green Bay, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.