Individual provider Active NPI

Dawn Rae Spence, C.O.T.A.

  • Occupational Therapy Assistant
  • Tomah, WI
National Provider Identifier
1831120732
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
140027 Issued in WI
Practice address
500 E Veterans St
Tomah, WI 54660-3105
Phone
(608) 372-3971
Fax
(608) 372-1724
NPI assigned
Jul 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 140027 WI Primary

Addresses

Primary practice location

500 E Veterans St
Tomah, WI 54660-3105

Mailing address

515 Schaller St
Tomah, WI 54660-2845
Phone (608) 372-3869

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
140027WIMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1831120732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 SCHALLER ST",
            "city": "TOMAH",
            "state": "WI",
            "postal_code": "546602845",
            "telephone_number": "608-372-3869",
            "fax_number": "608-372-1724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 E VETERANS ST",
            "city": "TOMAH",
            "state": "WI",
            "postal_code": "546603105",
            "telephone_number": "608-372-3971",
            "fax_number": "608-372-1724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPENCE",
        "first_name": "DAWN",
        "middle_name": "RAE",
        "name_prefix": "Mrs.",
        "credential": "C.O.T.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "WI",
            "license": "140027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tomah, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.