Individual provider Active NPI

Linda Marie Socker, OTR

  • Occupational Therapist
  • Green Bay, WI
National Provider Identifier
1609069608
Registry record updated Aug 22, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
AA569723 Issued in NU
Practice address
812 S Fisk Street
Suite 109
Green Bay, WI 54304
Phone
(920) 429-9936
NPI assigned
Aug 22, 2007
Last updated
Aug 22, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X AA569723 NU Primary
Pediatric Occupational Therapist 225XP0200X 1358 WI

Addresses

Primary practice location

812 S Fisk Street
Suite 109
Green Bay, WI 54304

Mailing address

812 S Fisk Street
Suite 109
Green Bay, WI 54304
Phone (920) 429-9936

Other identifiers 1

IdentifierTypeStateIssuer
40701100MedicaidWI

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

LicenseStateTypeSpecialty
1358WIMDCertified Registered Nurse Anesthetist

NPI Registry JSON

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

{
    "created_epoch": "1187740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187740800000",
    "number": "1609069608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "812 S FISK STREET",
            "address_2": "SUITE 109",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "54304",
            "telephone_number": "920-429-9936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "812 S FISK STREET",
            "address_2": "SUITE 109",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "54304",
            "telephone_number": "920-429-9936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOCKER",
        "first_name": "LINDA",
        "middle_name": "MARIE",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-22",
        "last_updated": "2007-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": "AA569723",
            "primary": true
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "WI",
            "license": "1358",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40701100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "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 Aug 22, 2007; 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.