Amie L Wilson, OTR

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

3556-26 Issued in WI

Practice address

402 First St
Random Lake, WI 53075-0323

Phone

(920) 994-9700

NPI assigned

Jul 13, 2010

Last updated

Jul 13, 2010By 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

Other names 1

• Amie L Janz Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mueller Therapy, Inc.

  • Occupational Therapist
  • Random Lake, WI
  • NPI 1578515755
  NPD (past)

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

{
    "created_epoch": "1278979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278979200000",
    "number": "1629380167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W7533 CHERRY HILL DR",
            "city": "ADELL",
            "state": "WI",
            "postal_code": "530011294",
            "telephone_number": "920-994-9495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 FIRST ST",
            "city": "RANDOM LAKE",
            "state": "WI",
            "postal_code": "530750323",
            "telephone_number": "920-994-9700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "AMIE",
        "middle_name": "L",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-13",
        "last_updated": "2010-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "3556-26",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMIE",
            "last_name": "JANZ",
            "middle_name": "L",
            "credential": "OTR",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Elizabeth Marie Theis
• Brenda M Veldboom, NP
• Gerald Linus Vogler, DDS
• Barbara Alice Weber, MD
• Badieh Widmer, OTR

• Occupational Therapist in Random Lake, WI
• Providers in Random Lake, WI by specialty
• Occupational Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2010; 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.