Active NPI
Jonathan Eggebrecht, OTR
- Occupational Therapist
- Milwaukee, WI
National Provider Identifier
1841524451
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 4746026
- Practice address
- 3540 S 43Rd St
Milwaukee, WI 53220-1502 - Phone
- (414) 541-1000
- Fax
- (414) 328-2159
- NPI assigned
- Sep 29, 2009
- Last updated
- Sep 29, 2009
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 4746026 | WI | Primary |
Addresses
Primary practice location
3540 S 43Rd St
Milwaukee, WI 53220-1502
Mailing address
441 W Bayfield Ave
Glendale, WI 53217-3404
Phone (414) 331-2045
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4746026 | WI | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1254182400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1254182400000",
"number": "1841524451",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "441 W BAYFIELD AVE",
"city": "GLENDALE",
"state": "WI",
"postal_code": "532173404",
"telephone_number": "414-331-2045"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3540 S 43RD ST",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532201502",
"telephone_number": "414-541-1000",
"fax_number": "414-328-2159"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EGGEBRECHT",
"first_name": "JONATHAN",
"credential": "OTR",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-09-29",
"last_updated": "2009-09-29",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "WI",
"license": "4746026",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Milwaukee, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.