Shelly Ann Lang, OTR

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

3350026 Issued in WI

Practice address

5595 County Road Z
West Bend, WI 53095-9224

Phone

(262) 306-2100

Fax

(262) 306-2128

NPI assigned

Nov 6, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Miss Shelly Ann Williams Other 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": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1649359894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 WASHINGTON AVE",
            "city": "KEWASKUM",
            "state": "WI",
            "postal_code": "530408902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5595 COUNTY ROAD Z",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "530959224",
            "telephone_number": "262-306-2100",
            "fax_number": "262-306-2128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANG",
        "first_name": "SHELLY",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "OTR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-06",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "3350026",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40860100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHELLY",
            "last_name": "WILLIAMS",
            "middle_name": "ANN",
            "prefix": "MISS",
            "credential": "OTR",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Lakeshore Wellness and Recovery Inc
• Liliya Lakshtanov
• Patricia L Landvatter
• Patricia D Lane
• Abbey Lang
• Ryan Douglas Langer, DNP
• Braden Percival Laporte
• Ashley Michelle Larock, APNP
• Tiffany L Larson, OT
• Elizabeth Laubach, PHARMD

• Occupational Therapist in West Bend, WI
• Providers in West Bend, 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 9, 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.