Individual provider Active NPI

Michelle Kiefer, OTR

  • Occupational Therapist
  • West Allis, WI
National Provider Identifier
1144658592
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
5051-026 Issued in WI
Practice address
9806 W Lincoln Ave
West Allis, WI 53227-2234
Phone
(414) 543-5330
NPI assigned
Oct 23, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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 5051-026 WI Primary

Addresses

Primary practice location

9806 W Lincoln Ave
West Allis, WI 53227-2234

Mailing address

N25W27115 Orchard LN
Pewaukee, WI 53072-4952
Phone (262) 347-5575

Other practice location 1

1130 Collins Rd
Jefferson, WI 53549-2939
Phone (920) 674-3170 ext. 1753

Other identifiers 1

IdentifierTypeStateIssuer
100041504MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180604001542 WI Practitioner - Occupational Therapist in Private Practice 5698030799 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fox Rehabilitation Services Wi LLCGroup PAC ID 1658647581, 144 clinicians

Practice addresses (Care Compare)

2130 Continental Dr
West Bend, WI 53095-7904
Phone (262) 338-0092

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5051-026WIMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Aegis Group Practice LLC Occupational Therapist Current Accepting new patients
Aegis Group Practice, LLC Occupational Therapist CurrentSince Apr 16, 2018 Accepting new patients
Aegis Group Practice LLC Occupational Therapist CurrentSince Apr 16, 2018 Accepting new patients
Fox Rehabilitation Services Wi LLC Occupational Therapist CurrentSince Oct 1, 2024 Accepting new patients

Locations

4933 Old Greenwood Rd
Fort Smith, AR 72903

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1382486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1144658592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N25W27115 ORCHARD LN",
            "city": "PEWAUKEE",
            "state": "WI",
            "postal_code": "530724952",
            "telephone_number": "262-347-5575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9806 W LINCOLN AVE",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532272234",
            "telephone_number": "414-543-5330"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1130 Collins Rd",
            "address_purpose": "LOCATION",
            "city": "Jefferson",
            "state": "WI",
            "postal_code": "535492939",
            "country_code": "US",
            "telephone_number": "920-674-3170 x1753",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIEFER",
        "first_name": "MICHELLE",
        "name_prefix": "Mrs.",
        "credential": "OTR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-10-23",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "5051-026",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100041504",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Allis, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.