Nicole Ann Prokash, MS

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

4928-026 Issued in WI

Practice address

1040 Pilgrim Way
Ashwaubenon, WI 54304-5028

Phone

(920) 405-3522

NPI assigned

Dec 14, 2010

Last updated

Sep 7, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1292284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662508800000",
    "number": "1790088672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "543 HILL RD",
            "city": "GREENLEAF",
            "state": "WI",
            "postal_code": "541269632",
            "telephone_number": "920-205-9757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 PILGRIM WAY",
            "city": "ASHWAUBENON",
            "state": "WI",
            "postal_code": "543045028",
            "telephone_number": "920-405-3522"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "304 S 1st Ave",
            "address_2": "Apt 15",
            "address_purpose": "LOCATION",
            "city": "Abbotsford",
            "state": "WI",
            "postal_code": "544059758",
            "country_code": "US",
            "telephone_number": "920-205-8757",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PROKASH",
        "first_name": "NICOLE",
        "middle_name": "ANN",
        "credential": "MS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-12-14",
        "last_updated": "2022-09-07",
        "certification_date": "2022-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "4928-026",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2022; 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.