Active NPI
Stephanie Clausen-Kubarth, OTR
- Occupational Therapist
- Racine, WI
National Provider Identifier
1952595977
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 42115
- Practice address
- 359 13TH Ave
Racine, WI 53403-9655 - Phone
- (292) 552-8989
- NPI assigned
- Sep 3, 2007
- Last updated
- Sep 3, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 Therapist | 225X00000X | 42115 | WI | Primary |
Addresses
Primary practice location
359 13TH Ave
Racine, WI 53403-9655
Mailing address
359 13TH Ave
Racine, WI 53403-9655
Phone (292) 552-8989
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 40896800 | Medicaid | WI |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 42115 | WI | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1188777600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1188777600000",
"number": "1952595977",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "359 13TH AVE",
"city": "RACINE",
"state": "WI",
"postal_code": "534039655",
"telephone_number": "292-552-8989"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "359 13TH AVE",
"city": "RACINE",
"state": "WI",
"postal_code": "534039655",
"telephone_number": "292-552-8989"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLAUSEN-KUBARTH",
"first_name": "STEPHANIE",
"credential": "OTR",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-09-03",
"last_updated": "2007-09-03",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "WI",
"license": "42115",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "40896800",
"state": "WI"
}
],
"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 Sep 3, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.