Wendy P Goldbach, OTD MED OTR CHT

Primary specialty

Hand Occupational TherapistTaxonomy code 225XH1200X

License

1092026 Issued in WI

Practice address

12800 N Lake Shore Dr
Mequon, WI 53097-2418

Phone

(262) 243-4261

Fax

(262) 243-4261

NPI assigned

Jan 31, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Education

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Gail a Weinand

  • Medical Specialty Clinic/Center
  • Rhinelander, WI
  • NPI 1881927812
  NPD (past)

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1740327618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2704 BIBLE CAMP RD",
            "city": "RHINELANDER",
            "state": "WI",
            "postal_code": "54501",
            "telephone_number": "715-490-2954",
            "fax_number": "715-282-7161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12800 N LAKE SHORE DR",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530972418",
            "telephone_number": "262-243-4261",
            "fax_number": "262-243-4261"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "201 Hospital Rd.",
            "address_2": "Eagle River Memorial Hospital",
            "address_purpose": "LOCATION",
            "city": "Eagle River",
            "state": "WI",
            "postal_code": "54521",
            "country_code": "US",
            "telephone_number": "715-479-4711",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOLDBACH",
        "first_name": "WENDY",
        "middle_name": "P",
        "credential": "OTD MED OTR CHT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-31",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": "WI",
            "license": "1092026",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1780663013",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40547700",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WISCONSIN STATE LICENSE",
            "identifier": "1092-26",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mariah Ann Goecke, D.C.
• Daniel Goeckner, PH.D.
• Robert Joseph Gogan, MD
• Susan Goggins
• Ramin Golchini, M.D.
• David F Goldberg, MD
• Renee Lynn Goldman, LMT
• Kristen Tess Gollnick, PT, DPT
• Howard J Gollup, MD
• Kevin Goniu, MD

• Hand Occupational Therapist in Mequon, WI
• Providers in Mequon, WI by specialty
• Hand Occupational Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.