Organization Active NPI

Pause for Healing, LLC

  • Neurorehabilitation Occupational Therapist
  • Brookfield, WI
National Provider Identifier
1760660377
Registry record updated Apr 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurorehabilitation Occupational TherapistTaxonomy code 225XN1300X
Legal business name
PAUSE FOR HEALING, LLC
Practice address
13965 W Burleigh Rd
Suite 103
Brookfield, WI 53005-3064
Phone
(414) 254-1565
Fax
(262) 378-4394
NPI assigned
Feb 6, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2008

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

Authorized official

Name
Kellie Jo Lindberg, OTRNPI 1861594210
Title
Occupational Therapist
Phone
(414) 254-1565

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurorehabilitation Occupational TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225XN1300X Primary

Addresses

Primary practice location

13965 W Burleigh Rd
Suite 103
Brookfield, WI 53005-3064

Mailing address

13965 W Burleigh Rd
Suite 103
Brookfield, WI 53005-3064
Phone (414) 254-1565

Other identifiers 2

IdentifierTypeStateIssuer
1861594210OtherINDIVIDUAL NPI
40898800MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080407000558 WI Part B Supplier - Clinic/Group Practice 0941387542 Receives reassigned benefits from 1 practitioner
Practice locations: Pewaukee, WI

National Provider Directory

National Provider Directory

Locations

13965 W Burleigh Rd
Ste 103
Brookfield, WI 53005
Phone (262) 785-1404

N27W23960 Paul Rd
Ste 4
Pewaukee, WI 53072
Phone (414) 254-1565

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1202256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209340800000",
    "number": "1760660377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13965 W BURLEIGH RD",
            "address_2": "SUITE 103",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530053064",
            "telephone_number": "414-254-1565",
            "fax_number": "262-378-4394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13965 W BURLEIGH RD",
            "address_2": "SUITE 103",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530053064",
            "telephone_number": "414-254-1565",
            "fax_number": "262-378-4394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAUSE FOR HEALING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-06",
        "last_updated": "2008-04-28",
        "status": "A",
        "authorized_official_last_name": "LINDBERG",
        "authorized_official_first_name": "KELLIE",
        "authorized_official_middle_name": "JO",
        "authorized_official_title_or_position": "OCCUPATIONAL THERAPIST",
        "authorized_official_telephone_number": "414-254-1565",
        "authorized_official_credential": "OTR"
    },
    "taxonomies": [
        {
            "code": "225XN1300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist, Neurorehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1861594210",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40898800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookfield, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2008; 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.