Active NPI
Morgan Balog, OTR/L
- Occupational Therapist
- West Allis, WI
National Provider Identifier
1962029207
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 6791-26
- Practice address
- 3023 S 84TH St
West Allis, WI 53227-3703 - Phone
- (414) 607-4100
- NPI assigned
- Jul 2, 2020
- 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 | 6791-26 | WI | Primary |
Addresses
Primary practice location
3023 S 84TH St
West Allis, WI 53227-3703
Mailing address
17280 W North Ave
Brookfield, WI 53045-4366
Phone (262) 928-8830
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | morgan.bushke@phci.org |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1593648000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1731888000000",
"number": "1962029207",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17280 W NORTH AVE",
"city": "BROOKFIELD",
"state": "WI",
"postal_code": "530454366",
"telephone_number": "262-928-8830"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3023 S 84TH ST",
"city": "WEST ALLIS",
"state": "WI",
"postal_code": "532273703",
"telephone_number": "414-607-4100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BALOG",
"first_name": "MORGAN",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-07-02",
"last_updated": "2024-11-18",
"certification_date": "2024-11-18",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "WI",
"license": "6791-26",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "morgan.bushke@phci.org",
"affiliation": "N",
"address_1": "17280 W North Ave",
"city": "Brookfield",
"state": "WI",
"country_code": "US",
"postal_code": "530454366",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in West Allis, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.