Individual provider Active NPI

Jan C Klemp, OTR

  • Occupational Therapist
  • Appleton, WI
National Provider Identifier
1063789436
Registry record updated Nov 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
1-26 Issued in WI
Practice address
1506 S Oneida St
Appleton, WI 54915-1305
Phone
(920) 738-2254
NPI assigned
Nov 29, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 1-26 WI Primary

Addresses

Primary practice location

1506 S Oneida St
Appleton, WI 54915-1305

Mailing address

1524 Lucerne Dr
Menasha, WI 54952-1611
Phone (920) 729-9742

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
1-26WIMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1322524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322524800000",
    "number": "1063789436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1524 LUCERNE DR",
            "city": "MENASHA",
            "state": "WI",
            "postal_code": "549521611",
            "telephone_number": "920-729-9742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1506 S ONEIDA ST",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549151305",
            "telephone_number": "920-738-2254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLEMP",
        "first_name": "JAN",
        "middle_name": "C",
        "name_prefix": "Ms.",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-29",
        "last_updated": "2011-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "1-26",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Appleton, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 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.