Eric Keith Tischendorf, COTA

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

857-027 Issued in WI

Practice address

112 E 5TH Ave
Antigo, WI 54409-2710

Phone

(715) 623-9449

NPI assigned

Mar 14, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1831222116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N1021 US HIGHWAY 45 S",
            "city": "ANTIGO",
            "state": "WI",
            "postal_code": "544098856",
            "telephone_number": "715-623-3363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 E 5TH AVE",
            "city": "ANTIGO",
            "state": "WI",
            "postal_code": "544092710",
            "telephone_number": "715-623-9449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TISCHENDORF",
        "first_name": "ERIC",
        "middle_name": "KEITH",
        "name_prefix": "Mr.",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-14",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "WI",
            "license": "857-027",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40746000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Nicholas Thiel
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• Gretchen L Tolsma, APNP
• Greta M Tomany, RN, CMF
• Ross Trecartin, MD
• James M Turnbull, MD

• Occupational Therapy Assistant in Antigo, WI
• Providers in Antigo, WI by specialty
• Occupational Therapy Assistant in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.