Kelsey Lange, OTD, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

121139 Issued in IA

Practice address

4121 Pennsylvania Ave
Dubuque, IA 52002-2628

Phone

(563) 583-4003

Fax

(563) 583-3408

NPI assigned

Jul 27, 2023

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Unified Therapy Services, Inc

  • Occupational Therapist
  • Fennimore, WI
  • NPI 1639727035
  NPD (past)

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

{
    "created_epoch": "1690416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701129600000",
    "number": "1023799590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4121 PENNSYLVANIA AVE",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520022628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4121 PENNSYLVANIA AVE",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520022628",
            "telephone_number": "563-583-4003",
            "fax_number": "563-583-3408"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4135 Pennsylvania Ave",
            "address_purpose": "LOCATION",
            "city": "Dubuque",
            "state": "IA",
            "postal_code": "520022678",
            "country_code": "US",
            "telephone_number": "563-583-4003",
            "fax_number": "563-583-3408",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1690 Elm St Ste 230",
            "address_purpose": "LOCATION",
            "city": "Dubuque",
            "state": "IA",
            "postal_code": "520013686",
            "country_code": "US",
            "telephone_number": "563-583-4003",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9179 Old Potosi Rd",
            "address_purpose": "LOCATION",
            "city": "Lancaster",
            "state": "WI",
            "postal_code": "538139437",
            "country_code": "US",
            "telephone_number": "563-583-4003",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LANGE",
        "first_name": "KELSEY",
        "credential": "OTD, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-27",
        "last_updated": "2023-11-28",
        "certification_date": "2023-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IA",
            "license": "121139",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Occupational Therapist in Dubuque, IA
• Providers in Dubuque, IA by specialty
• Occupational Therapist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2023; 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.