Individual provider Active NPI

Latasha Lynn Newbury, OTR/L

  • Occupational Therapist
  • Park Falls, WI
National Provider Identifier
1770133316
Registry record updated Jun 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
6617-26 Issued in WI
Practice address
98 Sherry Ave
Park Falls, WI 54552-1467
Phone
(715) 762-7470
NPI assigned
Sep 16, 2019
Last updated
Jun 16, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 6617-26 WI Primary

Addresses

Primary practice location

98 Sherry Ave
Park Falls, WI 54552-1467

Mailing address

1000 N Oak Ave FL 2
Marshfield, WI 54449-5703
Phone (715) 389-0636

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address him@marshfieldclinichealthsystem.cernerdirect.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230629001455 WI Practitioner - Occupational Therapist in Private Practice 9739548314 Reassigns benefits to 9 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6617-26WIMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeview Medical Center Inc of Rice Lake CurrentSince May 17, 2023 Accepting new patients
MCHS Hospitals Inc Current Accepting new patients
MCHS Hospitals Inc CurrentSince May 17, 2023 Accepting new patients
Flambeau Hospital Inc CurrentSince May 17, 2023 Accepting new patients
Beaver Dam Community Hospitals Inc CurrentSince May 17, 2023 Accepting new patients
Memorial Hospital Inc CurrentSince May 17, 2023 Accepting new patients
MCHS Hospitals Inc CurrentSince May 17, 2023 Accepting new patients
Flambeau Hospital Inc CurrentSince May 17, 2023 Accepting new patients
Lakeview Medical Center Inc of Rice Lake CurrentSince May 17, 2023 Accepting new patients
Marshfield Clinic Inc CurrentSince May 17, 2023 Accepting new patients
MCHS Hospitals Inc Current Accepting new patients
Beaver Dam Community Hospitals Inc CurrentSince May 17, 2023 Accepting new patients

Locations

705 S University Ave
Beaver Dam, WI 53916
Phone (920) 885-6090

3501 Golf Rd
Eau Claire, WI 54701
Phone (715) 858-4200

1000 N Oak Ave
Marshfield, WI 54449
Phone (715) 387-5111

1000 N Oak Ave
Fl 2
Marshfield, WI 54449

1102 S Center Ave
Merrill, WI 54452
Phone (715) 536-3399

N3708 River Ave
Neillsville, WI 54456
Phone (715) 743-3101

98 Sherry Ave
Park Falls, WI 54552
Phone (715) 762-2484

1700 W Stout St
Rice Lake, WI 54868
Phone (715) 236-6133

Interoperability endpoints

  • Direct secure messaging: him@marshfieldclinichealthsystem.cernerdirect.com

Organizations & group practices 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1568592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686873600000",
    "number": "1770133316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 N OAK AVE FL 2",
            "city": "MARSHFIELD",
            "state": "WI",
            "postal_code": "544495703",
            "telephone_number": "715-389-0636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "98 SHERRY AVE",
            "city": "PARK FALLS",
            "state": "WI",
            "postal_code": "545521467",
            "telephone_number": "715-762-7470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEWBURY",
        "first_name": "LATASHA",
        "middle_name": "LYNN",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-16",
        "last_updated": "2023-06-16",
        "certification_date": "2023-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "6617-26",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "him@marshfieldclinichealthsystem.cernerdirect.com",
            "affiliation": "N",
            "address_1": "98 Sherry Ave",
            "city": "Park Falls",
            "state": "WI",
            "country_code": "US",
            "postal_code": "545521467",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Park Falls, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2023; 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.