Marcia Ann Nelson, OTRL

Individual provider Active NPI Occupational Therapist · Thermopolis, WY

NPI 1043403199 · NPPES record last updated Aug 22, 2007

Key facts

NPI
1043403199
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
OTR027 (WY)
Practice address
1025 Shoshoni
Childrens Resource Center
Thermopolis, WY 82443
Phone
(307) 864-9227
Fax
(307) 864-2296
NPI assigned
Aug 22, 2007
Sex
Female
Sole proprietor
No

Organizations & group practices 2

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
OTR027WYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
William H and Carrie Gottsche Foundation Past
since Nov 1, 2005
Accepting new patients
Holistic Pain Management of Wyoming, LLC Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OTR027 WY Yes

Addresses

Primary practice location

1025 Shoshoni
Childrens Resource Center
Thermopolis, WY 82443

Mailing address

116 Judy Lee St
Thermopolis, WY 82443
Phone (307) 864-3376

Other identifiers

IdentifierTypeStateIssuer
1770688871MedicaidWY

Other names

  • Marcia Ann Kilponen Former name

Other providers in Thermopolis, WY

All providers in Thermopolis, WY · Occupational Therapist in Wyoming

Sources for this page

Verify at the official NPI Registry.