Active NPI
Ali Lynne Meinburg, OTA
- Occupational Therapy Assistant
- Colfax, WI
National Provider Identifier
1770827396
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 1080-27
- Practice address
- N8560 618TH St
Colfax, WI 54730-4609 - Phone
- (715) 704-6077
- NPI assigned
- Nov 20, 2012
- Sex
- Female
- Sole proprietor
- Yes
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 Therapy Assistant | 224Z00000X | 1080-27 | WI | Primary |
Addresses
Primary practice location
N8560 618TH St
Colfax, WI 54730-4609
Mailing address
N8560 618TH St
Colfax, WI 54730-4609
Phone (715) 704-6077
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1080-27 | Other | WI | WI OCCUPATIONAL THERAPY LICENSE |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1080-27 | WI | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1353369600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1353369600000",
"number": "1770827396",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "N8560 618TH ST",
"city": "COLFAX",
"state": "WI",
"postal_code": "547304609",
"telephone_number": "715-704-6077"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "N8560 618TH ST",
"city": "COLFAX",
"state": "WI",
"postal_code": "547304609",
"telephone_number": "715-704-6077"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEINBURG",
"first_name": "ALI",
"middle_name": "LYNNE",
"name_prefix": "Ms.",
"credential": "OTA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-11-20",
"last_updated": "2012-11-20",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "WI",
"license": "1080-27",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WI OCCUPATIONAL THERAPY LICENSE",
"identifier": "1080-27",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Colfax, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.