Mark Robert Tolsma, COTA

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

Practice address

1250 S Evergreen St
Shawano, WI 54166-3514

Phone

(715) 526-3107

NPI assigned

Jul 19, 2021

Sex

Male

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1626652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626652800000",
    "number": "1770156614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1029 W HARRIS ST",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549143857",
            "telephone_number": "920-266-7437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 S EVERGREEN ST",
            "city": "SHAWANO",
            "state": "WI",
            "postal_code": "541663514",
            "telephone_number": "715-526-3107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOLSMA",
        "first_name": "MARK",
        "middle_name": "ROBERT",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-19",
        "last_updated": "2021-07-19",
        "certification_date": "2021-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NBCOT",
            "identifier": "434591",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Thomas Thomas, MD
• Bentley Jessica Mae Thomason, MD
• Heidi Lee Thompson, P.T.A.
• Ann Renae Thornock, APNP - FAMILY
• Ty D Thornock, CRNA
• Ann M Tousignant, MD
• Tower Clock Eye Center SC
• Corrina Jolinda Tuma, PTA
• Under the Rainbow LLC
• Nicholas Uttecht

• Occupational Therapy Assistant in Shawano, WI
• Providers in Shawano, 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 Jul 19, 2021; 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.