Active NPI
Angela Irene Vancleve, COTA
- Occupational Therapy Assistant
- Oconto Falls, WI
National Provider Identifier
1861666588
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 2024-027
- Practice address
- 100 E. Highland Drive
Oconto Falls, WI 54154 - Phone
- (920) 848-3272
- NPI assigned
- Apr 14, 2008
- 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 | 2024-027 | WI | Primary |
Addresses
Primary practice location
100 E. Highland Drive
Oconto Falls, WI 54154
Mailing address
7517 W Cold Spring Rd
Greenfield, WI 53220-2814
Phone (414) 327-6603
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 11014100 | Medicaid | WI | |
| 390848401050 | Other | WI | BLUE CROSS |
| 11014110 | Medicaid | WI |
Other names 1
- Miss Angela Irene Kanzenbach
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 |
|---|---|---|---|
| 2024-027 | WI | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1208131200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1468195200000",
"number": "1861666588",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7517 W COLD SPRING RD",
"city": "GREENFIELD",
"state": "WI",
"postal_code": "532202814",
"telephone_number": "414-327-6603",
"fax_number": "414-327-5411"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 E. HIGHLAND DRIVE",
"city": "OCONTO FALLS",
"state": "WI",
"postal_code": "54154",
"telephone_number": "920-848-3272"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANCLEVE",
"first_name": "ANGELA",
"middle_name": "IRENE",
"name_prefix": "Mrs.",
"credential": "COTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-04-14",
"last_updated": "2016-07-11",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "WI",
"license": "2024-027",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "11014100",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "390848401050",
"state": "WI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "11014110",
"state": "WI"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "ANGELA",
"last_name": "KANZENBACH",
"middle_name": "IRENE",
"prefix": "MISS",
"credential": "COTA",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Oconto Falls, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.