NPIMap

Organization Active NPI

Kidworks, LLC

  • Occupational Therapist
  • Chesterton, IN
National Provider Identifier
1033295472
Registry record updated Apr 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
31003944A Issued in IN
Legal business name
KIDWORKS, LLC
Practice address
1120 S Calumet Rd Ste 3
Chesterton, IN 46304-3286
Phone
(219) 916-4960
Fax
(219) 764-2751
NPI assigned
Oct 27, 2006
Last updated
Apr 30, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2008

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

Authorized official

Name
Cynthia S Mangan
Title
Ceo
Phone
(219) 983-9675

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 32001204A IN
Physical Therapist 225100000X 05008714A IN
Physical Therapy Assistant 225200000X 06003228A IN
Occupational Therapist 225X00000X 31003944A IN Primary
Speech-Language Pathologist 235Z00000X 22003689A IN

Addresses

Primary practice location

1120 S Calumet Rd Ste 3
Chesterton, IN 46304-3286

Mailing address

1120 S Calumet Rd Ste 3
Chesterton, IN 46304-3286
Phone (219) 983-9675

Other identifiers 1

IdentifierTypeStateIssuer
200815860MedicaidIN

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209513600000",
    "number": "1033295472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 S CALUMET RD STE 3",
            "city": "CHESTERTON",
            "state": "IN",
            "postal_code": "463043286",
            "telephone_number": "219-983-9675",
            "fax_number": "219-983-9681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 S CALUMET RD STE 3",
            "city": "CHESTERTON",
            "state": "IN",
            "postal_code": "463043286",
            "telephone_number": "219-916-4960",
            "fax_number": "219-764-2751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDWORKS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-27",
        "last_updated": "2008-04-30",
        "status": "A",
        "authorized_official_last_name": "MANGAN",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "219-983-9675"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "IN",
            "license": "32001204A",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05008714A",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IN",
            "license": "06003228A",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IN",
            "license": "31003944A",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IN",
            "license": "22003689A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200815860",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesterton, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2008; 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.