Active NPI
Ida Lyn Stevenson, COTA/L
- Skilled Nursing Facility
- Monroe, WI
National Provider Identifier
1821265638
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- Practice address
- 2903 13TH St
Monroe, WI 53566-2245 - Phone
- (608) 558-6032
- NPI assigned
- May 12, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Primary |
Addresses
Primary practice location
2903 13TH St
Monroe, WI 53566-2245
Mailing address
2903 13TH St
Monroe, WI 53566-2245
Phone (608) 558-6032
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 057003252 | Other | IL | OCCUPATIONAL THERAPY ASSISTANT LISCENSE |
| 1902-27 | Other | WI | OCCUPATIONAL THERAPY ASSISTANT LISCENSE |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1210550400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603065600000",
"number": "1821265638",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2903 13TH ST",
"city": "MONROE",
"state": "WI",
"postal_code": "535662245",
"telephone_number": "608-558-6032"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2903 13TH ST",
"city": "MONROE",
"state": "WI",
"postal_code": "535662245",
"telephone_number": "608-558-6032"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEVENSON",
"first_name": "IDA",
"middle_name": "LYN",
"credential": "COTA/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-05-12",
"last_updated": "2020-10-19",
"certification_date": "2020-10-19",
"status": "A"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OCCUPATIONAL THERAPY ASSISTANT LISCENSE",
"identifier": "057003252",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OCCUPATIONAL THERAPY ASSISTANT LISCENSE",
"identifier": "1902-27",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Monroe, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.