Individual provider Active NPI

Amy Abelman Waldvogel, OTR/L

  • Occupational Therapist
  • Wisconsin Rapids, WI
National Provider Identifier
1891196614
Registry record updated Dec 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
5495-26 Issued in WI
Practice address
3541 Plover Rd
Wisconsin Rapids, WI 54494-2155
Phone
(715) 423-5423
Fax
(715) 423-1532
NPI assigned
Sep 11, 2014
Last updated
Dec 7, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2017

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 104654 MN
Occupational Therapist 225X00000X 5495-26 WI Primary
Occupational Therapist 225X00000X 5201008851 MI

Addresses

Primary practice location

3541 Plover Rd
Wisconsin Rapids, WI 54494-2155

Mailing address

3541 Plover Rd
Wisconsin Rapids, WI 54494-2155
Phone (715) 423-5423

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240522001007 WI Practitioner - Occupational Therapist in Private Practice 4880036862 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5201008851MIMDOccupational Therapist
104654MNMDOccupational Therapist
5495-26WIMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Aspirus Wausau Hospital, Inc. CurrentSince May 13, 2024 Accepting new patients
Aspirus Wausau Hospital, Inc. CurrentSince May 13, 2024 Accepting new patients
Aspirus Wausau Hospital, Inc. Current Accepting new patients
Therapies Plus LLC Occupational Therapist Past Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

333 Pine Ridge Blvd
Wausau, WI 54401
Phone (715) 847-2160

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1410393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512604800000",
    "number": "1891196614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3541 PLOVER RD",
            "city": "WISCONSIN RAPIDS",
            "state": "WI",
            "postal_code": "544942155",
            "telephone_number": "715-423-5423",
            "fax_number": "715-423-1532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3541 PLOVER RD",
            "city": "WISCONSIN RAPIDS",
            "state": "WI",
            "postal_code": "544942155",
            "telephone_number": "715-423-5423",
            "fax_number": "715-423-1532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALDVOGEL",
        "first_name": "AMY",
        "middle_name": "ABELMAN",
        "name_prefix": "Miss",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-11",
        "last_updated": "2017-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MN",
            "license": "104654",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "5495-26",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MI",
            "license": "5201008851",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wisconsin Rapids, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.