Individual provider Active NPI

Kelsey Leigh Kornaus, OTR

  • Occupational Therapist
  • Middleton, WI
National Provider Identifier
1063874188
Registry record updated Nov 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
5838-26 Issued in WI
Practice address
9401 Old Sauk Rd
Middleton, WI 53562-4409
Phone
(608) 203-8102
NPI assigned
Mar 28, 2016
Last updated
Nov 17, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2016

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 5838-26 WI Primary

Addresses

Primary practice location

9401 Old Sauk Rd
Middleton, WI 53562-4409

Mailing address

W9334 Bluff LN
Cambridge, WI 53523-9512
Phone (810) 516-3986

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)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1459123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479340800000",
    "number": "1063874188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W9334 BLUFF LN",
            "city": "CAMBRIDGE",
            "state": "WI",
            "postal_code": "535239512",
            "telephone_number": "810-516-3986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9401 OLD SAUK RD",
            "city": "MIDDLETON",
            "state": "WI",
            "postal_code": "535624409",
            "telephone_number": "608-203-8102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORNAUS",
        "first_name": "KELSEY",
        "middle_name": "LEIGH",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-28",
        "last_updated": "2016-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "5838-26",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middleton, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2016; 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.