Active NPI
Marilyn Larson, OTR
- Occupational Therapist
- Lake Mills, WI
National Provider Identifier
1629242060
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 1642-026
- Practice address
- 135 E Prospect St
Lake Mills, WI 53551-1238 - Phone
- (920) 648-2338
- NPI assigned
- Apr 16, 2008
- Last updated
- Apr 16, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 1642-026 | WI | Primary |
Addresses
Primary practice location
135 E Prospect St
Lake Mills, WI 53551-1238
Mailing address
135 E Prospect St
Lake Mills, WI 53551-1238
Phone (920) 648-2338
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 048414 | Other | WI | DPI LICENSE |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1642-026 | WI | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1208304000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1208304000000",
"number": "1629242060",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "135 E PROSPECT ST",
"city": "LAKE MILLS",
"state": "WI",
"postal_code": "535511238",
"telephone_number": "920-648-2338"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "135 E PROSPECT ST",
"city": "LAKE MILLS",
"state": "WI",
"postal_code": "535511238",
"telephone_number": "920-648-2338"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LARSON",
"first_name": "MARILYN",
"name_prefix": "Ms.",
"credential": "OTR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-04-16",
"last_updated": "2008-04-16",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "WI",
"license": "1642-026",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DPI LICENSE",
"identifier": "048414",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lake Mills, WI
- Lake Mills Emergency Medical Services Inc.
- Lake Mills Family Dental LLC
- Lake Mills Hometown Pharmacy LLC (Lake Mills Hometown Pharmacy)
- Elinor Kay Lancour, R.N.
- Nancy Eileen Lange, PHYSICAL THERAPIST
- Rebecca Diane Lauber, RN
- Lilac Springs Assisted Livings LLC
- Debra Ann Lins, MSED
- Katherine A Lothe, NP
- Sally Lynd
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.