Melinda R Grandaw, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

4827-26 Issued in WI

Practice address

2600 65TH Avenue
Osceola, WI 54020-4370

Phone

(715) 294-2111

Fax

(715) 294-5758

NPI assigned

Nov 10, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MN, WI2 enrollments

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mgrandaw211513@excellian.direct.allina.com

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.

• St. Croix Regional Medical Center

  • Critical Access Hospital
  • Saint Croix Falls, WI
  • NPI 1043240922

  MN, Occupational Therapist

  Medicare reassignment NPD
• St. Croix Regional Medical Center

  • Rural Health Clinic/Center
  • Balsam Lake, WI
  • NPI 1013423219
  NPD

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

{
    "created_epoch": "1163116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300060800000",
    "number": "1578634879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 218",
            "city": "OSCEOLA",
            "state": "WI",
            "postal_code": "540200218",
            "telephone_number": "715-294-2111",
            "fax_number": "715-294-5758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 65TH AVENUE",
            "city": "OSCEOLA",
            "state": "WI",
            "postal_code": "540204370",
            "telephone_number": "715-294-2111",
            "fax_number": "715-294-5758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANDAW",
        "first_name": "MELINDA",
        "middle_name": "R",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-10",
        "last_updated": "2011-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "4827-26",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MN",
            "license": "100675",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jean Faye Evans-Williams, MSW
• Wendy Field, RN
• Angela Marie Fjerstad, PA
• Joan M Flanders, PT
• Forefront Dermatology, S.C.
• Brian Keith Gray, D.C.
• Kristin Gullickson, BSN RN
• Mary Elizabeth Gustafson, PHARM.D.
• Richard Leslie Hafdahl, D.D.S.
• Rachel Hall, OTR

• Occupational Therapist in Osceola, WI
• Providers in Osceola, WI by specialty
• Occupational Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2011; 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.

Verify at the official NPI Registry.