Brenda Prange, COTA

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

1474-027 Issued in WI

Practice address

1350 River Run Dr
Wisconsin Rapids, WI 54494-5487

Phone

(715) 421-7130

NPI assigned

Jan 10, 2014

Last updated

Jan 10, 2014By the provider in NPPES

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

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": "1389312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389312000000",
    "number": "1609298678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3550 110TH ST S",
            "city": "WISCONSIN RAPIDS",
            "state": "WI",
            "postal_code": "544948604",
            "telephone_number": "715-213-9623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 RIVER RUN DR",
            "city": "WISCONSIN RAPIDS",
            "state": "WI",
            "postal_code": "544945487",
            "telephone_number": "715-421-7130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRANGE",
        "first_name": "BRENDA",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-10",
        "last_updated": "2014-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "WI",
            "license": "1474-027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jalynn Piller, RN
• Pinnacle Performance Therapy LLC
• Wasana Pinsonneault, APNP
• Jessica Pompo, APRN, FNP-C
• Jesse Portillo, LPC
• John Henry Prey, D.D.S.
• Louanne Pufall, CSAC
• Rachel Pulkinen, PA-C
• Nicole Marie Pyan, LAT, ATC
• Taisa Rae Quinnell

• Occupational Therapy Assistant in Wisconsin Rapids, WI
• Providers in Wisconsin Rapids, 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 Jan 10, 2014; 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.