Ida Cole, PT, OT
Individual provider Active NPI Occupational Therapist · Appleton, WI
NPI 1992933683 · NPPES record last updated Jul 1, 2009
Key facts
- NPI
- 1992933683
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapist 225X00000X
- License
- 001454-1 (NY)
- Practice address
- 1650 Tri Park Way
Suite a
Appleton, WI 54914-1652 - Phone
- (920) 830-6697
- Fax
- (920) 830-6707
- NPI assigned
- Jul 1, 2009
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 005618-1 | NY | MD | Physical Therapist |
| 001454-1 | NY | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Blankenheim Occupational Therapy | Occupational Therapist | Past | Accepting new patients |
| Blankenheim Services, LLC | Physical Therapist | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 005618-1 | NY | |
| Occupational Therapist | 225X00000X | 001454-1 | NY | Yes |
Addresses
Primary practice location
1650 Tri Park Way
Suite a
Appleton, WI 54914-1652
Mailing address
1650 Tri Park Way
Suite a
Appleton, WI 54914-1652
Phone (920) 830-6697
Other names
- Ida Medina
Other providers in Appleton, WI
- Thomas G Cody
- Michelle A Coenen
- Steven Ronald Coenen
- Carol Jean Cole
- Elizabeth Cole
- Benjamin A Coleman
- Phyllis Andrea Collar
- Riann Sue Collar
- Kimberly Collins
- Kylie Colotti
All providers in Appleton, WI · Occupational Therapist in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 1, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.