Brenda Mae Grissom, OTR

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

4870-026 Issued in WI

Practice address

3014 Erie Ave
Sheboygan, WI 53081-3658

Phone

(920) 459-3028

Fax

(920) 459-4341

NPI assigned

Nov 9, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Paxxon Healthcare Services LLCGroup PAC ID 8325959554, 153 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Paxxon Healthcare Services LLC

  • Physical Therapist
  • Menomonee Falls, WI
  • NPI 1003174087

  Occupational Therapist

  Medicare reassignment Care Compare group NPD
• Paxxon Healthcare Services LLC

  • Physical Therapist
  • Colorado Springs, CO
  • NPI 1336808146

  Occupational Therapist

  NPD

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

{
    "created_epoch": "1289260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667174400000",
    "number": "1780985648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5764 COUNTY ROAD Q",
            "city": "COLGATE",
            "state": "WI",
            "postal_code": "530179717",
            "telephone_number": "262-573-6130",
            "fax_number": "262-573-6130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3014 ERIE AVE",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530813658",
            "telephone_number": "920-459-3028",
            "fax_number": "920-459-4341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRISSOM",
        "first_name": "BRENDA",
        "middle_name": "MAE",
        "name_prefix": "Ms.",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-09",
        "last_updated": "2022-10-31",
        "certification_date": "2022-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "4870-026",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel J Gretebeck, MS, CSAC
• Lori A Gretz
• Anthony J Gries, PT
• Laura Martha Griffin, MS, ATR-BC
• Daniel Paul Grimm, D.C.
• Amanda J Groll, LPC
• Gregory S Grose, MD
• Grounded Roots Chiropractic LLC
• Grube Anesthesia Services, LLC
• Paul Anthony Gruber, DDS

• Occupational Therapist in Sheboygan, WI
• Providers in Sheboygan, WI by specialty
• Occupational Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.