Lori J Paczkowski, COTA

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

4679-27 Issued in WI

Practice address

425 Summit St
Wild Rose, WI 54984-6804

Phone

(920) 622-3750

Fax

(920) 622-3752

NPI assigned

Aug 9, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1249776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351814400000",
    "number": "1992937932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 DOUGLAS AVE",
            "city": "MONTELLO",
            "state": "WI",
            "postal_code": "539499322",
            "telephone_number": "608-369-0004",
            "fax_number": "920-622-3752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 SUMMIT ST",
            "city": "WILD ROSE",
            "state": "WI",
            "postal_code": "549846804",
            "telephone_number": "920-622-3750",
            "fax_number": "920-622-3752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACZKOWSKI",
        "first_name": "LORI",
        "middle_name": "J",
        "name_prefix": "Ms.",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-09",
        "last_updated": "2012-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "WI",
            "license": "4679-27",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1992937932",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Midwest Wisconsin Corporate Guardianship, Inc.
• Sabahat Mohsin, MD
• Lynn Marie Bielmeier Momsen, DDS
• Jennifer Kay Mueller, OTR
• Osl WR Operating LLC
• Susan Melissa Piechowski, APNP
• Jayden Ellouise Prondzinski
• Tina Marie Rich, RN
• Lynn Annette Ringenoldus, APNP
• Timothy R Roberts, MD

• Occupational Therapy Assistant in Wild Rose, WI
• Providers in Wild Rose, WI by specialty
• Occupational Therapy Assistant in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2012; 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.