Andrea Hermsen, COTA

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

4571 Issued in WI

Practice address

2131 S Business Dr
Sheboygan, WI 53081-5656

Phone

(920) 803-1617

Fax

(920) 803-1622

NPI assigned

Jun 29, 2020

Last updated

Jun 29, 2020By the provider in NPPES

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

• Andrea Klockow Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Progressive Beginnings, LLC

  • Rehabilitation Clinic/Center
  • Sheboygan, WI
  • NPI 1598886152
  NPD

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

{
    "created_epoch": "1593388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593388800000",
    "number": "1750908448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2131 S BUSINESS DR",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530815656",
            "telephone_number": "920-803-1617",
            "fax_number": "920-803-1622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2131 S BUSINESS DR",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530815656",
            "telephone_number": "920-803-1617",
            "fax_number": "920-803-1622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERMSEN",
        "first_name": "ANDREA",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-29",
        "last_updated": "2020-06-29",
        "certification_date": "2020-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "WI",
            "license": "4571",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41813000",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.progbeg.com",
            "affiliation": "N",
            "address_1": "2131 S Business Dr",
            "city": "Sheboygan",
            "state": "WI",
            "country_code": "US",
            "postal_code": "530815656",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ANDREA",
            "last_name": "KLOCKOW",
            "credential": "COTA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Tammy Sue Henschel, LPN
• Mai Soua Her, DNP
• Ann M Hering, OTR
• Travis Scott Hering, LAT,ATC
• John P Hermann, MD
• Jacqueline Marie Hernandez, LPN
• John Hernandez, APNP
• Jeffrey A Herold, M.D.
• Suzanne S Herold, MD
• Abby Herrmann

• Occupational Therapy Assistant in Sheboygan, WI
• Providers in Sheboygan, 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 Jun 29, 2020; 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.