Active NPI
Jessica Marie Degroot, OTR
- Occupational Therapist
- Chilton, WI
National Provider Identifier
1952838534
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 6006
- Practice address
- 614 Memorial Dr
Chilton, WI 53014-1568 - Phone
- (920) 849-2386
- NPI assigned
- May 15, 2017
- 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 | 6006 | WI | Primary |
Addresses
Primary practice location
614 Memorial Dr
Chilton, WI 53014-1568
Mailing address
11 Algoma St
Fond Du Lac, WI 54935-3601
Phone (920) 979-0194
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6006 | WI | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1494806400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1494806400000",
"number": "1952838534",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11 ALGOMA ST",
"city": "FOND DU LAC",
"state": "WI",
"postal_code": "549353601",
"telephone_number": "920-979-0194"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "614 MEMORIAL DR",
"city": "CHILTON",
"state": "WI",
"postal_code": "530141568",
"telephone_number": "920-849-2386"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEGROOT",
"first_name": "JESSICA",
"middle_name": "MARIE",
"credential": "OTR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-05-15",
"last_updated": "2017-05-15",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "WI",
"license": "6006",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chilton, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.