Active NPI
Sarah Sue Greene, OTR/L
- Occupational Therapist
- Hudson, WI
National Provider Identifier
1770679060
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 4201
- Practice address
- 2705 Enloe St
Hudson, WI 54016-8173 - Phone
- (715) 386-2128
- Fax
- (715) 386-6119
- NPI assigned
- Oct 5, 2006
- Last updated
- Jul 9, 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 | 4201 | WI | Primary |
Addresses
Primary practice location
2705 Enloe St
Hudson, WI 54016-8173
Mailing address
2683 Leyland TRL
Woodbury, MN 55125-3571
Phone (651) 207-6087
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 97G20GR | Other | MN | BCBS MN |
| 15665 | Other | HEALTH PARTNERS | |
| 3582973 | Other | AETNA | |
| 6404786 | Other | MEDICA | |
| 40877300 | Medicaid | WI | |
| 641671046996 | Other | PREFERRED ONE |
Other names 1
- Sarah Sue Goltz
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4201 | WI | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160006400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1770679060",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2683 LEYLAND TRL",
"city": "WOODBURY",
"state": "MN",
"postal_code": "551253571",
"telephone_number": "651-207-6087"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2705 ENLOE ST",
"city": "HUDSON",
"state": "WI",
"postal_code": "540168173",
"telephone_number": "715-386-2128",
"fax_number": "715-386-6119"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREENE",
"first_name": "SARAH",
"middle_name": "SUE",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-05",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "WI",
"license": "4201",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS MN",
"identifier": "97G20GR",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH PARTNERS",
"identifier": "15665",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "3582973",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA",
"identifier": "6404786",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "40877300",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFERRED ONE",
"identifier": "641671046996",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"first_name": "SARAH",
"last_name": "GOLTZ",
"middle_name": "SUE",
"credential": "OTR/L",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Hudson, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.