Individual provider Active NPI

Marin Stauffacher, COTA

  • Occupational Therapy Assistant
  • Janesville, WI
National Provider Identifier
1699474031
Registry record updated Dec 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
7279-27 Issued in WI
Practice address
101 E Milwaukee St Ste 507
Janesville, WI 53545-3004
Phone
(608) 728-7774
Fax
(608) 621-3804
NPI assigned
Feb 24, 2023
Last updated
Dec 19, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 7279-27 WI Primary
Behavior Analyst 103K00000X RBT-23-259875 WI

Addresses

Primary practice location

101 E Milwaukee St Ste 507
Janesville, WI 53545-3004

Mailing address

101 E Milwaukee St Ste 507
Janesville, WI 53545-3004
Phone (608) 728-7774

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
RBT-23-259875WIMDBehavioral Analyst
7279-27WIMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Marigold Speech Pathology Services, LLC CurrentSince Dec 21, 2025 Accepting new patients
KGH Consultation & Treatment, Inc. Behavior Analyst PastSince Feb 26, 2023 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1677196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766102400000",
    "number": "1699474031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 E MILWAUKEE ST STE 507",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "535453004",
            "telephone_number": "608-728-7774",
            "fax_number": "608-621-3804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 E MILWAUKEE ST STE 507",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "535453004",
            "telephone_number": "608-728-7774",
            "fax_number": "608-621-3804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAUFFACHER",
        "first_name": "MARIN",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-24",
        "last_updated": "2025-12-19",
        "certification_date": "2025-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "WI",
            "license": "7279-27",
            "primary": true
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "WI",
            "license": "RBT-23-259875",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Janesville, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2025; 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.