Active NPI
Bethany Lyn Ellwanger, MS, OTR
- Occupational Therapist
- Chippewa Falls, WI
National Provider Identifier
1952672701
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 5141
- Practice address
- 2509 County Highway I
HSHS St Joseph'S Spots
Chippewa Falls, WI 54729-2785 - Phone
- (715) 726-3590
- Fax
- (715) 717-7613
- NPI assigned
- Jan 25, 2012
- 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 Therapist | 225X00000X | 5141 | WI | Primary |
Addresses
Primary practice location
2509 County Highway I
HSHS St Joseph'S Spots
Chippewa Falls, WI 54729-2785
Mailing address
2661 County Highway I
HSHS St Joseph'S Hospital Spots
Chippewa Falls, WI 54729-5407
Phone (715) 726-3590
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5141 | Other | WI | WISCONSIN LICENSE |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | bellwanger108691@ewd.direct.hshs.org | Direct |
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
- Credentials
- Master of Science
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1327449600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1641340800000",
"number": "1952672701",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2661 COUNTY HIGHWAY I",
"address_2": "HSHS ST JOSEPH'S HOSPITAL SPOTS",
"city": "CHIPPEWA FALLS",
"state": "WI",
"postal_code": "547295407",
"telephone_number": "715-726-3590",
"fax_number": "715-717-7613"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2509 COUNTY HIGHWAY I",
"address_2": "HSHS ST JOSEPH'S SPOTS",
"city": "CHIPPEWA FALLS",
"state": "WI",
"postal_code": "547292785",
"telephone_number": "715-726-3590",
"fax_number": "715-717-7613"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLWANGER",
"first_name": "BETHANY",
"middle_name": "LYN",
"credential": "MS, OTR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-01-25",
"last_updated": "2022-01-05",
"certification_date": "2022-01-05",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "WI",
"license": "5141",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WISCONSIN LICENSE",
"identifier": "5141",
"state": "WI"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "bellwanger108691@ewd.direct.hshs.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "CDA/CCD/TXT",
"address_1": "2509 County Highway I",
"address_2": "HSHS St Joseph's SPOTS",
"city": "Chippewa Falls",
"state": "WI",
"country_code": "US",
"postal_code": "547292785",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Chippewa Falls, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.