NPIMap

Rebekah K Pogwizd, OT

Individual provider Active NPI Occupational Therapist · Fox Point, WI

NPI 1659719342 · NPPES record last updated Jun 19, 2014

Key facts

NPI
1659719342
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
5417-26 (WI)
Practice address
6908 N Santa Monica Blvd
Fox Point, WI 53217-3942
Phone
(414) 352-2082
Fax
(414) 352-5279
NPI assigned
Jun 5, 2013
Sex
Female
Sole proprietor
No

Organizations & group practices 1

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
056-010182ILMDOccupational Therapist
5417-26WIMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Allina Health System Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 056-010182 IL
Occupational Therapist 225X00000X 5417-26 WI Yes

Addresses

Primary practice location

6908 N Santa Monica Blvd
Fox Point, WI 53217-3942

Mailing address

212 S Barclay St
Apt 407
Milwaukee, WI 53204-1433
Phone (715) 820-1312

Other providers in Fox Point, WI

All providers in Fox Point, WI · Occupational Therapist in Wisconsin

Sources for this page

Verify at the official NPI Registry.