Individual provider Active NPI

Katie Jo Burnham, OT, CHT

  • Occupational Therapist
  • Oak Creek, WI
National Provider Identifier
1992021133
Registry record updated Jun 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
4822 Issued in WI
Practice address
7901 S 6TH St
Oak Creek, WI 53154-2010
Phone
(414) 346-8000
NPI assigned
Apr 13, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 4822 WI Primary

Addresses

Primary practice location

7901 S 6TH St
Oak Creek, WI 53154-2010

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909

Other practice location 1

N15W28300 Golf Rd
Pewaukee, WI 53072-4800
Phone (262) 303-5055

Other identifiers 1

IdentifierTypeStateIssuer
100009504MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121105000671 WI Practitioner - Occupational Therapist in Private Practice 1254582943 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

W180N8085 Town Hall Rd
FL 3
Menomonee Falls, WI 53051-3518
Phone (262) 251-1000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4822WIMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince Sep 25, 2023 Accepting new patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince Sep 25, 2023 Accepting new patients
The Medical College of Wisconsin, Inc. Current Accepting new patients
Athletic & Therapeutic Institute of Milwaukee, LLC Occupational Therapist CurrentSince Nov 26, 2023 Accepting new patients
Athletic & Therapeutic Institute of Milwaukee, LLC Occupational Therapist CurrentSince Nov 26, 2023 Accepting new patients
Athletic & Therapeutic Institute of Milwaukee, LLC Occupational Therapist Current Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

W168N11237 Western Ave
Germantown, WI 53022
Phone (262) 253-5060

W180N8085 Town Hall Rd
Fl 3
Menomonee Falls, WI 53051

N74W12501 Leatherwood Ct
Menomonee Falls, WI 53051
Phone (414) 454-4744

11430 N Port Washington Rd
Mequon, WI 53092
Phone (262) 518-1900

S74W16867 Janesville Rd
Muskego, WI 53150
Phone (262) 971-4200

7901 S 6th St
Oak Creek, WI 53154
Phone (414) 346-8000

1155 N Mayfair Rd
Wauwatosa, WI 53226
Phone (414) 955-5990

201 N Mayfair Rd
Fl 2
Wauwatosa, WI 53226
Phone (414) 771-8228

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1271116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719187200000",
    "number": "1992021133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7901 S 6TH ST",
            "city": "OAK CREEK",
            "state": "WI",
            "postal_code": "531542010",
            "telephone_number": "414-346-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "N15W28300 Golf Rd",
            "address_purpose": "LOCATION",
            "city": "Pewaukee",
            "state": "WI",
            "postal_code": "530724800",
            "country_code": "US",
            "telephone_number": "262-303-5055",
            "fax_number": "262-303-5057",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BURNHAM",
        "first_name": "KATIE",
        "middle_name": "JO",
        "name_prefix": "Mrs.",
        "credential": "OT, CHT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-13",
        "last_updated": "2024-06-24",
        "certification_date": "2024-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "4822",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100009504",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Creek, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.