Active NPI
Briana M Harris, OTD, OTR/L
- Occupational Therapist
- La Crosse, WI
National Provider Identifier
1669619946
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 5870
- Practice address
- 531 Main St
La Crosse, WI 54601-4022 - Phone
- (608) 812-8787
- NPI assigned
- Jan 8, 2009
- 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 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 056.011559 | IL | |
| Pediatric Occupational Therapist | 225XP0200X | OT8266 | CA | |
| Pediatric Occupational Therapist | 225XP0200X | 5870 | WI | |
| Occupational Therapist | 225X00000X | 5870 | WI | Primary |
Addresses
Primary practice location
531 Main St
La Crosse, WI 54601-4022
Mailing address
531 Main St
La Crosse, WI 54601-4022
Phone (608) 812-8787
Other practice location 1
920 Wi-16
West Salem, WI 54669-1952
Phone (608) 812-8787
Other practice location 2
9833 Woods Dr
Skokie, IL 60077-1104
Phone (847) 663-1020 ext. 173
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669619946 | Medicaid | WI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220803003598 | WI | Practitioner - Occupational Therapist in Private Practice | 1850770769 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 056.011559 | IL | MD | Occupational Therapist |
| OT8266 | CA | MD | Pediatric Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1231372800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1644192000000",
"number": "1669619946",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "531 MAIN ST",
"city": "LA CROSSE",
"state": "WI",
"postal_code": "546014022",
"telephone_number": "608-812-8787"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "531 MAIN ST",
"city": "LA CROSSE",
"state": "WI",
"postal_code": "546014022",
"telephone_number": "608-812-8787"
}
],
"practiceLocations": [
{
"address_1": "920 WI-16",
"address_purpose": "LOCATION",
"city": "West Salem",
"state": "WI",
"postal_code": "546691952",
"country_code": "US",
"telephone_number": "608-812-8787",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "9833 Woods Dr",
"address_purpose": "LOCATION",
"city": "Skokie",
"state": "IL",
"postal_code": "600771104",
"country_code": "US",
"telephone_number": "847-663-1020 x173",
"fax_number": "847-663-1022",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HARRIS",
"first_name": "BRIANA",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "OTD, OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-01-08",
"last_updated": "2022-02-07",
"certification_date": "2022-02-07",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "IL",
"license": "056.011559",
"primary": false
},
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "CA",
"license": "OT8266",
"primary": false
},
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "WI",
"license": "5870",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "WI",
"license": "5870",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1669619946",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in La Crosse, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.