Individual provider Active NPI

Stacey K Zahn, OCCUPATIONAL THERAP

  • Occupational Therapist
  • Brookfield, WI
National Provider Identifier
1780887745
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
574026 Issued in WI
Practice address
19525 W North Ave
Wheaton Franciscan Healthcare Marian Franciscan Service
Brookfield, WI 53045
Phone
(262) 785-1114
Fax
(262) 780-3805
NPI assigned
Jun 7, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 574026 WI Primary

Addresses

Primary practice location

19525 W North Ave
Wheaton Franciscan Healthcare Marian Franciscan Service
Brookfield, WI 53045

Mailing address

2812 S Conger PL
West Allis, WI 53227
Phone (414) 327-7440

Other identifiers 1

IdentifierTypeStateIssuer
40718200MedicaidWI

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

LicenseStateTypeSpecialty
574026WIMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1181174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1780887745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2812 S CONGER PL",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "53227",
            "telephone_number": "414-327-7440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19525 W NORTH AVE",
            "address_2": "WHEATON FRANCISCAN HEALTHCARE MARIAN FRANCISCAN SERVICE",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "53045",
            "telephone_number": "262-785-1114",
            "fax_number": "262-780-3805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAHN",
        "first_name": "STACEY",
        "middle_name": "K",
        "name_prefix": "Mrs.",
        "credential": "OCCUPATIONAL THERAP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "574026",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40718200",
            "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 Jul 8, 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.

Verify at the official NPI Registry.