NPIMap

Individual provider Active NPI

John Paul Kilmer, OTR/L

  • Occupational Therapist
  • Omaha, NE
National Provider Identifier
1063703577
Registry record updated May 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT002923 Issued in WA
Practice address
11850 Nicholas St Ste 100
Omaha, NE 68154-4476
Phone
(402) 505-4670
NPI assigned
May 2, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 2, 2011

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT-975 ID
Occupational Therapist 225X00000X OT002923 WA Primary
Occupational Therapist 225X00000X OT 10244 CA

Addresses

Primary practice location

11850 Nicholas St Ste 100
Omaha, NE 68154-4476

Mailing address

PO Box 48462
Spokane, WA 99228-1462
Phone (509) 638-9177

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
OT 10244CAMDOccupational Therapist
OT-975IDMDOccupational Therapist
OT002923WAMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1304294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1304294400000",
    "number": "1063703577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 48462",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992281462",
            "telephone_number": "509-638-9177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11850 NICHOLAS ST STE 100",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681544476",
            "telephone_number": "402-505-4670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KILMER",
        "first_name": "JOHN",
        "middle_name": "PAUL",
        "name_prefix": "Mr.",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-05-02",
        "last_updated": "2011-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "ID",
            "license": "OT-975",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WA",
            "license": "OT002923",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "OT 10244",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2011; 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.