Active NPI
Ashley Liebe, COTA
- Occupational Therapy Assistant
- Racine, WI
National Provider Identifier
1851861504
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 4687-27
- Practice address
- 1320 S Green Bay Road
Racine, WI 53406 - Phone
- (262) 886-3431
- NPI assigned
- Nov 26, 2018
- Sex
- Female
- Sole proprietor
- No
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 Therapy Assistant | 224Z00000X | 4687-27 | WI | Primary |
Addresses
Primary practice location
1320 S Green Bay Road
Racine, WI 53406
Mailing address
10540 S Jessica Dr
Oak Creek, WI 53154-6492
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
| License | State | Type | Specialty |
|---|---|---|---|
| 4687-27 | WI | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1543190400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1543190400000",
"number": "1851861504",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10540 S JESSICA DR",
"city": "OAK CREEK",
"state": "WI",
"postal_code": "531546492"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1320 S GREEN BAY ROAD",
"city": "RACINE",
"state": "WI",
"postal_code": "53406",
"telephone_number": "262-886-3431"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIEBE",
"first_name": "ASHLEY",
"name_prefix": "Mrs.",
"credential": "COTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-11-26",
"last_updated": "2018-11-26",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "WI",
"license": "4687-27",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Racine, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.