Individual provider Active NPI

Edward Richard Sauld, COTA

  • Occupational Therapy Assistant
  • New Berlin, WI
National Provider Identifier
1699442376
Registry record updated Aug 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
4889-27 Issued in WI
Practice address
2725 S Moorland Rd Ste 301
New Berlin, WI 53151-3720
Phone
(414) 329-2432
Fax
(414) 329-2509
NPI assigned
Aug 30, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 30, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 4889-27 WI Primary

Addresses

Primary practice location

2725 S Moorland Rd Ste 301
New Berlin, WI 53151-3720

Mailing address

367 N Westhaven Dr Apt 104
Oshkosh, WI 54904-5427
Phone (906) 221-5303

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
4889-27WIMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1630281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630281600000",
    "number": "1699442376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "367 N WESTHAVEN DR APT 104",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549045427",
            "telephone_number": "906-221-5303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2725 S MOORLAND RD STE 301",
            "city": "NEW BERLIN",
            "state": "WI",
            "postal_code": "531513720",
            "telephone_number": "414-329-2432",
            "fax_number": "414-329-2509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAULD",
        "first_name": "EDWARD",
        "middle_name": "RICHARD",
        "credential": "COTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-08-30",
        "last_updated": "2021-08-30",
        "certification_date": "2021-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "WI",
            "license": "4889-27",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Berlin, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2021; 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.