Individual provider Active NPI

Marlene Irene Haertig, OTR

  • Occupational Therapist
  • Waukesha, WI
National Provider Identifier
1851588560
Registry record updated Sep 26, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
109-026 Issued in WI
Practice address
1451 Cleveland Ave
Waukesha, WI 53186-3876
Phone
(262) 547-2123
Fax
(262) 547-6214
NPI assigned
Sep 26, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 109-026 WI Primary

Addresses

Primary practice location

1451 Cleveland Ave
Waukesha, WI 53186-3876

Mailing address

1451 Cleveland Ave
Waukesha, WI 53186-3876
Phone (262) 547-2123

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
109-026WIMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1190764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190764800000",
    "number": "1851588560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1451 CLEVELAND AVE",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531863876",
            "telephone_number": "262-547-2123",
            "fax_number": "262-547-6214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1451 CLEVELAND AVE",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531863876",
            "telephone_number": "262-547-2123",
            "fax_number": "262-547-6214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAERTIG",
        "first_name": "MARLENE",
        "middle_name": "IRENE",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-26",
        "last_updated": "2007-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "109-026",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waukesha, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 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.