Individual provider Active NPI

Holly Ruth Persinger, MOTR/L

  • Occupational Therapist
  • Sheboygan, WI
National Provider Identifier
1659044600
Registry record updated Feb 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
7046-26 Issued in WI
Practice address
3821 Kohler Memorial Dr Ste 102
Sheboygan, WI 53081-3600
Phone
(920) 208-9648
NPI assigned
Jul 27, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 7046-26 WI Primary

Addresses

Primary practice location

3821 Kohler Memorial Dr Ste 102
Sheboygan, WI 53081-3600

Mailing address

19395 W Capitol Dr Ste 200
Brookfield, WI 53045-2736
Phone (262) 923-7101

Other identifiers 1

IdentifierTypeStateIssuer
907401090OtherILUNITEDHEALTHCARE

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
7046-26WIMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Rehab Resources Inc PastSince Aug 1, 2021 Accepting new patients
Greenfield Rehabilitation Agency, Inc. Occupational Therapist PastSince Aug 1, 2021 Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1627344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675814400000",
    "number": "1659044600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19395 W CAPITOL DR STE 200",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530452736",
            "telephone_number": "262-923-7101",
            "fax_number": "262-923-7178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3821 KOHLER MEMORIAL DR STE 102",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530813600",
            "telephone_number": "920-208-9648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERSINGER",
        "first_name": "HOLLY",
        "middle_name": "RUTH",
        "credential": "MOTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-27",
        "last_updated": "2023-02-08",
        "certification_date": "2023-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "7046-26",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITEDHEALTHCARE",
            "identifier": "907401090",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sheboygan, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2023; 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.