Mary Beth Zondlak, COTA

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

4701-027 Issued in WI

Practice address

1807 Paso Roble Way
Madison, WI 53716-2418

Phone

(262) 620-1680

NPI assigned

Nov 6, 2009

Last updated

Nov 6, 2009By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1257465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257465600000",
    "number": "1548597875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1807 PASO ROBLE WAY",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537162418",
            "telephone_number": "262-620-1680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1807 PASO ROBLE WAY",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537162418",
            "telephone_number": "262-620-1680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZONDLAK",
        "first_name": "MARY",
        "middle_name": "BETH",
        "name_prefix": "Ms.",
        "credential": "COTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-11-06",
        "last_updated": "2009-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "WI",
            "license": "4701-027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Occupational Therapy Assistant in Madison, WI
• Providers in Madison, WI by specialty
• Occupational Therapy Assistant in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.