MR. MARC DOMINIC BAZZANELLA (NPI# 1144516188) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144516188 |
| Entity Type | Individual |
| Full Name | MR. MARC DOMINIC BAZZANELLA |
| Practice Address |
4502 Milwaukee St Madison WI 53714-2133 |
| Mailing Address |
29 Pleasant Oak Ct Oregon WI 53575-3225 |
| Practice Telephone | 6082492137 |
| Mailing Telephone | 8312780465 |
| Enumeration Date | 2011-06-28 |
| Last Update Date | 2012-07-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225X00000X | Occupational Therapist | 5218-26 | WI | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
4502 MILWAUKEE ST |
| City | MADISON |
| State | WI |
| Zip Code | 53714-2133 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386639458 | Karmenta Center, LLC | Skilled Nursing Facility | 4502 Milwaukee St, Madison, WI 53714-2133 | 2005-09-15 |
| 1578055869 | Melanie Leistikow | Speech-Language Pathologist | 4502 Milwaukee St, Madison, WI 53714-2133 | 2018-06-01 |
| 1235500414 | Laura Sandry | Physical Therapy Assistant | 4502 Milwaukee St, Madison, WI 53714-2133 | 2015-10-13 |
| 1578964722 | Tiffany S. Johnson | Speech-Language Pathologist | 4502 Milwaukee St, Madison, WI 53714-2133 | 2014-09-08 |
| 1215348339 | Jaclyn Lefebvre | Occupational Therapist | 4502 Milwaukee St, Madison, WI 53714-2133 | 2014-05-12 |
| 1619310679 | Jennifer Adams | Physical Therapy Assistant | 4502 Milwaukee St, Madison, WI 53714-2133 | 2013-04-09 |
| 1083926240 | Caroline Willis Powers | Physical Therapist | 4502 Milwaukee St, Madison, WI 53714-2133 | 2010-07-05 |
| 1003127036 | Leslie L. Lord | Speech-Language Pathologist | 4502 Milwaukee St, Madison, WI 53714-2133 | 2010-06-24 |
| 1154642429 | Elizabeth J Anderson | Occupational Therapy Assistant | 4502 Milwaukee St, Madison, WI 53714-2133 | 2010-06-21 |
| 1083845465 | Nicole Sier | Speech-Language Pathologist | 4502 Milwaukee St, Madison, WI 53714-2133 | 2009-08-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265069421 | Access Elevator, Inc. | Contractor | 4229 Argosy Ct., Suite 2b, Madison, WI 53714 | 2020-03-26 |
| 1629426762 | Bethany Domoto | Occupational Therapist | 210 Dempsey Rd, Madison, WI 53714 | 2016-05-31 |
| 1871984989 | Warren Family Dental | Dentist | 4226 Milwaukee Street, Madison, WI 53714 | 2015-02-11 |
| 1316103567 | Heather Marie Kramer | Occupational Therapy Assistant | 5755 Burke Rd, Madison, WI 53714 | 2008-08-06 |
| 1841402906 | Genesis Eldercare Rehab Services | Occupational Therapist | 4502 Milwaukee Street, Madison, WI 53714 | 2007-05-03 |
| 1902928872 | Christine Haag | Dentist | 758 Corporate Dr., Suite 201, Madison, WI 53714 | 2007-04-04 |
| 1366958522 | Dana Johanek | Acupuncturist | 4222 Milwaukee St, 17, Madison, WI 53714 | 2017-12-22 |
| 1003338575 | Lacrima M Goldberg | Dentist | 826 Atlas Ave, Madison, WI 53714 | 2017-07-17 |
| 1497127120 | Kimberly Ann Klein | Occupational Therapist | 4502 Milwaukee Street, Madison, WI 53714 | 2015-10-21 |
| 1437310604 | Pediatric Dental Specialists of Madison LLC | Dentist | 49 N Walbridge Ave, Madison, WI 53714 | 2008-06-20 |
| Find all providers in zip 53714 | ||||
| Taxonomy Code | 225X00000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Occupational Therapist |
| An occupational therapist is a person who has graduated from an entry-level occupational therapy program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE) or predecessor organizations, or approved by the World Federation of Occupational Therapists (WFOT), or an equivalent international occupational therapy education program; has successfully completed a period of supervised fieldwork experience required by the occupational therapy program; has passed a nationally recognized entry-level examination for occupational therapists, and fulfills state requirements for licensure, certification, or registration. An occupational therapist provides interventions based on evaluation and which emphasize the therapeutic use of everyday life activities (i.e., occupations) with individuals or groups for the purpose of facilitating participation in roles and situations and in home, school, workplace, community and other settings. Occupational therapy services are provided for the purpose of promoting health and wellness and are provided to those who have or are at risk for developing an illness, injury, disease, disorder, condition, impairment, disability, activity limitation, or participation restriction. Occupational therapists address the physical, cognitive, psychosocial, sensory, and other aspects of occupational performance in a variety of contexts to support engagement in everyday life activities that affect health, well-being, and quality of life. |
| Notes: Source: The Guide to Occupational Therapy Practice, 2nd edition. Bethesda: American Occupational Therapy Association, 2007. [7/1/2008: definition changed, added source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639780398 | Jenna Zavetz | Occupational Therapist | 1994 Gallatin Pike N Ste 202, Madison, TN 37115-2024 | 2020-08-14 |
| 1093357956 | Jill Sharon Broderick | Occupational Therapist | 37 Kings Rd Ste 101, Madison, NJ 07940-2500 | 2019-10-11 |
| 1265080444 | Meri Claire Soldevila | Occupational Therapist | 1820 August Bnd, Madison, MS 39110-6825 | 2019-08-30 |
| 1285287243 | Nancilynn Dickey | Occupational Therapist | 7712 Old Canton Rd Unit B, Madison, MS 39110-9299 | 2019-07-18 |
| 1770060964 | Sprout Pediatric Therapy, LLC | Occupational Therapist | 108 Serenity Way, Madison, MS 39110-6992 | 2018-07-20 |
| 1558855890 | Taylor Crawford Lee | Occupational Therapist | 7712 Old Canton Rd Ste B, Madison, MS 39110-9299 | 2018-06-20 |
| 1275027005 | Andrew Joseph Witmer | Occupational Therapist | 429 S Yellowstone Dr, Madison, WI 53719-1021 | 2018-06-15 |
| 1689176323 | Magnolia Pediatric Therapy, LLC | Occupational Therapist | 239 Clark Farms Rd, Madison, MS 39110-8115 | 2018-03-07 |
| 1902308547 | Samantha Danz | Occupational Therapist | 1033 High St Apt 126, Madison, WI 53715-1928 | 2018-02-28 |
| 1578063657 | Noreen Annika Jeglum | Occupational Therapist | 501 N Whitney Way Apt 4, Madison, WI 53705-2745 | 2018-02-15 |
| Find all providers in MADISON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.