Beth Anne Eliszewski

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

965 Issued in WI

Practice address

1922 CTH-NN
Elkhorn, WI 53121

Phone

(262) 741-3600

NPI assigned

May 8, 2007

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

• Beth Anne Fields Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1178582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613088000000",
    "number": "1710190327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "S88W25970 EDGEWOOD AVE",
            "city": "MUKWONAGO",
            "state": "WI",
            "postal_code": "531498542",
            "telephone_number": "414-614-4146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1922 CTH-NN",
            "city": "ELKHORN",
            "state": "WI",
            "postal_code": "53121",
            "telephone_number": "262-741-3600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELISZEWSKI",
        "first_name": "BETH",
        "middle_name": "ANNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-08",
        "last_updated": "2021-02-12",
        "certification_date": "2021-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "WI",
            "license": "965",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40735900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BETH",
            "last_name": "FIELDS",
            "middle_name": "ANNE",
            "credential": "COTA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Amanda Marie Duckworth, RDH
• E F Chiropractic Inc (Elkhorn Family Chiropractic)
• Cailyn Ebler, CCC-SLP
• Lauren Eder
• Susan Marie Egan, MSN,FNP-C
• Elkhorn Area School District
• Elkhorn Family Chiropractic LLC
• Elkhorn Family Clinic
• Elkhorn Family Dentistry LLC
• Elkhorn Pharmacy LTD

• Occupational Therapy Assistant in Elkhorn, WI
• Providers in Elkhorn, WI by specialty
• Occupational Therapy Assistant in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 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.