Wholistic Occupational Therapy LLC

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

992026 Issued in WI

Legal business name

WHOLISTIC OCCUPATIONAL THERAPY LLC

Practice address

6320 W North Ave
Wauwatosa, WI 53213-2013

Phone

(414) 258-2981

Fax

(414) 774-0082

NPI assigned

Dec 15, 2011

Organization subpart

No

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

Authorized official

Name

Ms. Diane M. Halloran, O.T.NPI 1295885358

Title

Owner/Therapist

Phone

(414) 258-2981

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Diane M. Halloran, O.T.

  • Occupational Therapist
  • Wauwatosa, WI
  • NPI 1295885358
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1323907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323907200000",
    "number": "1790054070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6320 W NORTH AVE",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532132013",
            "telephone_number": "414-258-2981",
            "fax_number": "414-774-0082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6320 W NORTH AVE",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532132013",
            "telephone_number": "414-258-2981",
            "fax_number": "414-774-0082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHOLISTIC OCCUPATIONAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-15",
        "last_updated": "2011-12-15",
        "status": "A",
        "authorized_official_last_name": "HALLORAN",
        "authorized_official_first_name": "DIANE",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "OWNER/THERAPIST",
        "authorized_official_telephone_number": "414-258-2981",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "O.T."
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "992026",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.