Tammy Joanne Moothedan, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

999386 Issued in MN

Practice address

1629 E Division St
River Falls, WI 54022-1571

Phone

(715) 307-6050

NPI assigned

Oct 8, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Tammy Joanne Lazzaro Former name

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": "1286496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667260800000",
    "number": "1598075541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1629 E DIVISION ST",
            "city": "RIVER FALLS",
            "state": "WI",
            "postal_code": "540221571",
            "telephone_number": "651-404-1399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1629 E DIVISION ST",
            "city": "RIVER FALLS",
            "state": "WI",
            "postal_code": "540221571",
            "telephone_number": "715-307-6050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOOTHEDAN",
        "first_name": "TAMMY",
        "middle_name": "JOANNE",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-08",
        "last_updated": "2022-11-01",
        "certification_date": "2022-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MN",
            "license": "999386",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TAMMY",
            "last_name": "LAZZARO",
            "middle_name": "JOANNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Matthew John Miller, LPC, SAC
• Molly Elizabeth Miller, MPT
• Gary Mitchell, LMT, CPT
• Thomas Francis Monahan, M.D.
• Amaris Moore, M.D.
• Amber Morgan, MD
• Benjamin Reid Morgan, MD
• Nealee Morrison
• Jena Marie Most, RN
• Louis Raymond Musser, DDS

• Occupational Therapist in River Falls, WI
• Providers in River Falls, WI by specialty
• Occupational Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2022; 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.