NPI Details
GOOD SHEPHERD HOME, LTD is an occupational therapist in Seymour, WI. The provider is 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. GOOD SHEPHERD HOME, LTD NPI is 1114995164. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Good Shepherd Rehabilitation Agency.
The provider's business location address is:
958 FOOTE STREET
SEYMOUR, WI
ZIP 54165
Phone: (920) 833-7796
Fax: (920) 833-2220
The provider's authorized official is Deborah A Captain .
The authorized official title is Executive Director and has the following contact phone number (920) 833-6856.
The CLIA number assigned to this NPI record is 52D0394570 - skilled nursing facility/nursing facility with a certificate type of Certificate of Waiver.
The enumeration date for this NPI number is 3/8/2006 and was last updated on 1/12/2012.
Taxonomy Codes
The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:
| No. |
Taxonomy Code |
Taxonomy Clasification |
Taxonomy Specialization |
License Number |
License State |
Primary |
| 1 | 225100000X | Physical Therapist | | 2659 | WISCONSIN | No |
| 2 | 235Z00000X | Speech-Language Pathologist | | 2659 | WISCONSIN | No |
| 3 | 225X00000X | Occupational Therapist | | 2659 | WISCONSIN | Yes |
Other Identifiers
The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.
| No. |
Other Provider Identifier |
Other Provider Identifier Type |
Other Provider Identifier State |
Other Provider Identifier Issuer |
| 1 | 526540 | MEDICARE OSCAR/CERTIFICATION | WISCONSIN | |
| 2 | 41814400 | MEDICAID | WISCONSIN | |
