Meagan Marie Derksen, COTA/L

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

4965-27 Issued in WI

Practice address

2131 S Business Dr
Sheboygan, WI 53081-5656

Phone

(920) 803-1617

Fax

(920) 803-1622

NPI assigned

Apr 2, 2014

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

Other identifiers 1

Other names 1

• Meagan Marie Wichterman Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Progressive Beginnings, LLC

  • Rehabilitation Clinic/Center
  • Sheboygan, WI
  • NPI 1598886152
  NPD (past)

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

{
    "created_epoch": "1396396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396396800000",
    "number": "1902224330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2131 S BUSINESS DR",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530815656",
            "telephone_number": "920-803-1617",
            "fax_number": "920-803-1622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2131 S BUSINESS DR",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530815656",
            "telephone_number": "920-803-1617",
            "fax_number": "920-803-1622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERKSEN",
        "first_name": "MEAGAN",
        "middle_name": "MARIE",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-02",
        "last_updated": "2014-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "WI",
            "license": "4965-27",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "4965-27",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MEAGAN",
            "last_name": "WICHTERMAN",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jennifer V Delp, PT
• Abigail Rose Demaster, PA-C
• Jacob Tait Demaster, D.O.
• Faith Demunck
• Monica J Demuth, APRN BC NP
• Jan P Deroos, MD
• Tanya Desarmo, LCSW
• Philip M. Detrana, M.D.
• Jennifer Dewey, RDH
• Gurminder Dhillon, MD

• Occupational Therapy Assistant in Sheboygan, WI
• Providers in Sheboygan, WI by specialty
• Occupational Therapy Assistant in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2014; 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.