Individual provider Active NPI

Timothy J Baumann, OTA

  • Occupational Therapy Assistant
  • Beaver Dam, WI
National Provider Identifier
1790089795
Registry record updated Jan 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
399-27 Issued in WI
Practice address
W9018 County Rd S
Beaver Dam, WI 53916-9680
Phone
(608) 429-2181
NPI assigned
Jan 5, 2011
Last updated
Jan 5, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 5, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 399-27 WI Primary

Addresses

Primary practice location

W9018 County Rd S
Beaver Dam, WI 53916-9680

Mailing address

W9018 County Rd S
Beaver Dam, WI 53916-9680
Phone (608) 429-2181

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
399-27WIMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
NSH Summit LLC Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1294185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294185600000",
    "number": "1790089795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W9018 COUNTY RD S",
            "city": "BEAVER DAM",
            "state": "WI",
            "postal_code": "539169680",
            "telephone_number": "608-429-2181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W9018 COUNTY RD S",
            "city": "BEAVER DAM",
            "state": "WI",
            "postal_code": "539169680",
            "telephone_number": "608-429-2181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUMANN",
        "first_name": "TIMOTHY",
        "middle_name": "J",
        "credential": "OTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-01-05",
        "last_updated": "2011-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "WI",
            "license": "399-27",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaver Dam, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2011; 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.