Natalie Grandahl, MOT

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

5751 Issued in WI

Practice address

17700 W Capitol Dr
Brookfield, WI 53045-2006

Phone

(262) 781-3083

Fax

(262) 781-3080

NPI assigned

Jan 28, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Natalie Black Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1643328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643328000000",
    "number": "1831842087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17700 W CAPITOL DR # 6",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530452006",
            "telephone_number": "262-781-3083",
            "fax_number": "262-781-3080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17700 W CAPITOL DR",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530452006",
            "telephone_number": "262-781-3083",
            "fax_number": "262-781-3080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANDAHL",
        "first_name": "NATALIE",
        "credential": "MOT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-28",
        "last_updated": "2022-01-28",
        "certification_date": "2022-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "5751",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NATALIE",
            "last_name": "BLACK",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Occupational Therapist in Brookfield, WI
• Providers in Brookfield, WI by specialty
• Occupational Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2022; 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.