Individual provider Active NPI

Heidi L Bruene, MOTR

  • Pediatric Occupational Therapist
  • Mequon, WI
National Provider Identifier
1992806558
Registry record updated Oct 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
3908-26 Issued in WI
Practice address
1486 W Mequon Rd
Mequon, WI 53092-3268
Phone
(262) 241-8030
NPI assigned
Sep 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X 3908-26 WI Primary

Addresses

Primary practice location

1486 W Mequon Rd
Mequon, WI 53092-3268

Mailing address

3236 Twin Creeks Rd
Jackson, WI 53037-8912
Phone (262) 420-8282

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

LicenseStateTypeSpecialty
3908-26WIMDPediatric Occupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633478400000",
    "number": "1992806558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3236 TWIN CREEKS RD",
            "city": "JACKSON",
            "state": "WI",
            "postal_code": "530378912",
            "telephone_number": "262-420-8282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1486 W MEQUON RD",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530923268",
            "telephone_number": "262-241-8030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUENE",
        "first_name": "HEIDI",
        "middle_name": "L",
        "credential": "MOTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-26",
        "last_updated": "2021-10-06",
        "certification_date": "2021-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "WI",
            "license": "3908-26",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mequon, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.