Michele Jean Ellingsberg, OT

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

3951026 Issued in WI

Practice address

645 N Church St
Elkhorn, WI 53121-2204

Phone

(262) 741-5549

Fax

(262) 723-6753

NPI assigned

Feb 9, 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

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Muslim Community and Health Center of Wisconsin Inc

  • Community Health Clinic/Center
  • Milwaukee, WI
  • NPI 1962850768

  WI

  Medicare reassignment NPD
• Comprehensive Podiatry Services

  • Foot & Ankle Surgery Podiatrist
  • Milwaukee, WI
  • NPI 1134885809
  NPD

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

{
    "created_epoch": "1139443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627948800000",
    "number": "1750354734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "645 N CHURCH ST",
            "city": "ELKHORN",
            "state": "WI",
            "postal_code": "531212204",
            "telephone_number": "262-741-5549",
            "fax_number": "262-780-0717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "645 N CHURCH ST",
            "city": "ELKHORN",
            "state": "WI",
            "postal_code": "531212204",
            "telephone_number": "262-741-5549",
            "fax_number": "262-723-6753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLINGSBERG",
        "first_name": "MICHELE",
        "middle_name": "JEAN",
        "name_prefix": "Mrs.",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-09",
        "last_updated": "2021-08-03",
        "certification_date": "2021-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "3951026",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elkhorn Family Dentistry LLC
• Elkhorn Pharmacy LTD
• Elkhorn Pharmacy LTD
• Elkhorn Pharmacy LTD
• Kim M Ellingham, NP
• Kelly T Enger, MS, LPC, NCC
• Enlightened Journey Counseling LLC
• Eye Physicians and Surgeons SC
• Family Dental Arts, S.C.
• Sean Patrick Fauls, MS, LPC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.