Active NPI
Tiffany Werner, OTR
- Occupational Therapist
- Superior, WI
National Provider Identifier
1962584250
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 3072
- Practice address
- 39 N 25TH St E
Superior, WI 54880-5269 - Phone
- (763) 689-5385
- NPI assigned
- Oct 19, 2006
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 102008 | MN | |
| Occupational Therapist | 225X00000X | 3072 | WI | Primary |
Addresses
Primary practice location
39 N 25TH St E
Superior, WI 54880-5269
Mailing address
5151 Munger Shaw Rd
Saginaw, MN 55779-9523
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 130G4WE | Other | MN | BCBS |
| HP48697 | Other | MN | HEALTH PARTNERS |
| 6405163 | Other | MN | MEDIDA |
| 41810700 | 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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 102008 | MN | MD | Occupational Therapist |
| 3072 | WI | MD | Adult Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161216000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1962584250",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5151 MUNGER SHAW RD",
"city": "SAGINAW",
"state": "MN",
"postal_code": "557799523"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "39 N 25TH ST E",
"city": "SUPERIOR",
"state": "WI",
"postal_code": "548805269",
"telephone_number": "763-689-5385"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WERNER",
"first_name": "TIFFANY",
"credential": "OTR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-19",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MN",
"license": "102008",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "WI",
"license": "3072",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "130G4WE",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH PARTNERS",
"identifier": "HP48697",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDIDA",
"identifier": "6405163",
"state": "MN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "41810700",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Superior, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.