Nancy Ann Bellendorf, OTR

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

592-026 Issued in WI

Practice address

103 S Gibson St
Medford, WI 54451

Phone

(715) 748-8112

Fax

(715) 748-8792

NPI assigned

Oct 2, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Nancy Ann Haas Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184025600000",
    "number": "1700979309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 S GIBSON ST",
            "city": "MEDFORD",
            "state": "WI",
            "postal_code": "544511622",
            "telephone_number": "715-748-8100",
            "fax_number": "715-748-8199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 S GIBSON ST",
            "city": "MEDFORD",
            "state": "WI",
            "postal_code": "54451",
            "telephone_number": "715-748-8112",
            "fax_number": "715-748-8792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELLENDORF",
        "first_name": "NANCY",
        "middle_name": "ANN",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2007-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "592-026",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40624400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NANCY",
            "last_name": "HAAS",
            "middle_name": "ANN",
            "credential": "OTR",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Occupational Therapist in Medford, WI
• Providers in Medford, WI by specialty
• Occupational Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2007; 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.