Amanda J Braden, OTR/L

Primary specialty

ContractorTaxonomy code 171W00000X

License

0056-007841 Issued in IL

Practice address

N2195 Beech Blvd
Lake Geneva, WI 53147-4424

Phone

(262) 206-1567

Fax

(262) 248-9479

NPI assigned

Feb 7, 2008

Last updated

Feb 7, 2008By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Pediatrics in Motion

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  • Gurnee, IL
  • NPI 1003094996
  Authorized official Same address or phone

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

{
    "created_epoch": "1202342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202342400000",
    "number": "1902084346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N2195 BEECH BLVD",
            "city": "LAKE GENEVA",
            "state": "WI",
            "postal_code": "531474424",
            "telephone_number": "262-206-1567",
            "fax_number": "262-248-9479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N2195 BEECH BLVD",
            "city": "LAKE GENEVA",
            "state": "WI",
            "postal_code": "531474424",
            "telephone_number": "262-206-1567",
            "fax_number": "262-248-9479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADEN",
        "first_name": "AMANDA",
        "middle_name": "J",
        "name_prefix": "Mrs.",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-07",
        "last_updated": "2008-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "IL",
            "license": "0056-007841",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maisie Boehm, LAT
• Ashley E. Boro, OT
• Kenneth B. Bortin, MD
• Susan Lynn Bosman, OTR
• Braden Dental Center SC
• Mark Thomas Braden, DDS
• Ryan Thomas Braden
• Joseph S Brantman, M.D.
• Brenda Brauer
• Mary Brauer, PT

• Contractor in Lake Geneva, WI
• Providers in Lake Geneva, WI by specialty
• Contractor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2008; 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.