Active NPI
Timothy Robert McDonnell, OTR
- Occupational Therapist
- Milwaukee, WI
National Provider Identifier
1740475276
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OC007741L
- Practice address
- 111 W Michigan St
Milwaukee, WI 53203-2903 - Phone
- (570) 724-5270
- Fax
- (570) 724-5276
- NPI assigned
- Sep 7, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OC007741L | PA | Primary |
Addresses
Primary practice location
111 W Michigan St
Milwaukee, WI 53203-2903
Mailing address
111 W Michigan St
Milwaukee, WI 53203-2903
Phone (570) 724-5270
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 40585200 | Medicaid | WI |
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
| License | State | Type | Specialty |
|---|---|---|---|
| OC007741L | PA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1189123200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1189123200000",
"number": "1740475276",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 W MICHIGAN ST",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532032903",
"telephone_number": "570-724-5270",
"fax_number": "570-724-5276"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 W MICHIGAN ST",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532032903",
"telephone_number": "570-724-5270",
"fax_number": "570-724-5276"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCDONNELL",
"first_name": "TIMOTHY",
"middle_name": "ROBERT",
"credential": "OTR",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-09-07",
"last_updated": "2007-09-07",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "PA",
"license": "OC007741L",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "40585200",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Milwaukee, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 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.