NPIMap

Taylor Marie Baldridge, OTR/L

Individual provider Active NPI Occupational Therapist · Green Bay, WI

NPI 1790428985 · NPPES record last updated Oct 12, 2022

Key facts

NPI
1790428985
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
726426 (WI)
Practice address
1727 Shawano Ave
Green Bay, WI 54303-3268
Phone
(920) 496-4700
NPI assigned
Apr 15, 2022
Sex
Female
Sole proprietor
No

Organizations & group practices 19

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.

Medicare Care Compare profile

Specialty
Occupational Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Vincent Hospital-Hospital Sisters-Third Order of St Francis (593 clinicians)

Practice addresses (Care Compare)

1727 Shawano Ave
Green Bay, WI 54303-3268
Phone (920) 496-4700

Merit-based Incentive Payment System (MIPS)

Final score
94.81 of 100 (apm)
Quality
85.98
Promoting interoperability
100
Improvement activities
40

Medicare participation

Medicare fee-for-service enrollment
Enrolled in WI

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20220509002524 WI Practitioner - Occupational Therapist in Private Practice 9335526557 Reassigns benefits to 2 organizations

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
726426WIMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
St Nicholas Hospital-Sisters of the Third Order of St Francis Current
since May 1, 2022		 Accepting new patients
St Vincent Hospital-Hospital Sisters-Third Order of St Francis Current
since May 1, 2022		 Accepting new patients
St Vincent Hospital-Hospital Sisters-Third Order of St Francis Occupational Therapist Current
since May 1, 2022		 Accepting new patients
St. Nicholas Hospital-Sisters of the Third Order of St Francis Occupational Therapist Current Accepting new patients
St. Nicholas Hospital-Sisters of the Third Order of St Francis Current
since May 1, 2022		 Accepting new patients
St Vincent Hospital-Hospital Sisters-Third Order of St Francis Past Accepting new patients

Locations

1727 Shawano Ave
Green Bay, WI 54303
Phone (920) 431-1810

835 S Van Buren St
Green Bay, WI 54301
Phone (888) 901-7246

3100 Superior Ave
Sheboygan, WI 53081
Phone (800) 472-6710

Interoperability endpoints

  • Direct secure messaging: tbaldridge317674@ewd.direct.hshs.org

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 726426 WI Yes

Addresses

Primary practice location

1727 Shawano Ave
Green Bay, WI 54303-3268

Mailing address

2477 Curtis CT
Green Bay, WI 54311-6753
Phone (262) 501-6504

Other identifiers

IdentifierTypeStateIssuer
726426OtherWIWI STATE

Electronic endpoints

TypeEndpointUseAffiliation
Direct Messaging Address tbaldridge317674@ewd.direct.hshs.org Direct

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Oct 12, 2022.

{
    "created_epoch": "1649980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665532800000",
    "number": "1790428985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2477 CURTIS CT",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543116753",
            "telephone_number": "262-501-6504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1727 SHAWANO AVE",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543033268",
            "telephone_number": "920-496-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALDRIDGE",
        "first_name": "TAYLOR",
        "middle_name": "MARIE",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-15",
        "last_updated": "2022-10-12",
        "certification_date": "2022-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "726426",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WI STATE",
            "identifier": "726426",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tbaldridge317674@ewd.direct.hshs.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "1727 Shawano Ave",
            "city": "Green Bay",
            "state": "WI",
            "country_code": "US",
            "postal_code": "543033268",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Green Bay, WI

All providers in Green Bay, WI · Occupational Therapist in Wisconsin

Sources for this page

Verify at the official NPI Registry.