Active NPI
Jennifer Brooke Shimon, OTR
- Occupational Therapist
- Port Washington, WI
National Provider Identifier
1750565487
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 3537026
- Practice address
- 1119 N Wisconsin St
Port Washington, WI 53074-1209 - Phone
- (262) 284-5892
- NPI assigned
- Dec 17, 2007
- Sex
- Female
- 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 | 3537026 | WI | Primary |
Addresses
Primary practice location
1119 N Wisconsin St
Port Washington, WI 53074-1209
Mailing address
1512 Audubon Ave
Grafton, WI 53024-2219
Phone (262) 375-0931
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 |
|---|---|---|---|
| 3537026 | WI | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1197849600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1197849600000",
"number": "1750565487",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1512 AUDUBON AVE",
"city": "GRAFTON",
"state": "WI",
"postal_code": "530242219",
"telephone_number": "262-375-0931"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1119 N WISCONSIN ST",
"city": "PORT WASHINGTON",
"state": "WI",
"postal_code": "530741209",
"telephone_number": "262-284-5892"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHIMON",
"first_name": "JENNIFER",
"middle_name": "BROOKE",
"credential": "OTR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-12-17",
"last_updated": "2007-12-17",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "WI",
"license": "3537026",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Port Washington, WI
- Lori Marie Schultz, CERTIFIED NURSING AS
- Brittany Schwarten, LCSW
- Second Opinion PHD LLC (EncourageU)
- Victoria Irene Miller Sepulveda, PH.D., LPC, CSAC, NC
- Rachael Sheets, LCSW
- Timothy J Shininger, LCSW LMFT
- Shopko Stores Operating Co LLC (ShopKo Pharmacy 503)
- Angella Adelle Siegel, OTR
- Cheryl L Simon, RN
- Simplistic Nutrition LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 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.