Active NPI
Carrie M Kies, OTR
- Occupational Therapist
- Appleton, WI
National Provider Identifier
1164568150
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 2705
- Practice address
- 3305 N Ballard Rd Ste C
Appleton, WI 54911-9001 - Phone
- (920) 735-9234
- NPI assigned
- Jan 29, 2007
- Last updated
- Jul 9, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 2705 | WI | Primary |
Addresses
Primary practice location
3305 N Ballard Rd Ste C
Appleton, WI 54911-9001
Mailing address
5193 High Pointe Dr
Winneconne, WI 54986-8642
Phone (920) 582-4465
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Occupational Therapist in Private Practice
- Education
- Other, 1994
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
825 Cobblestone LN
Kimberly, WI 54136-2116
Phone (800) 444-6845
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aegis Group Practice LLC | Occupational Therapist | Current | Accepting new patients |
| Aegis Group Practice LLC | Occupational Therapist | Current | Accepting new patients |
| Aegis Group Practice LLC | Occupational Therapist | Current | Accepting new patients |
| Valley-Bay Therapy Inc. | Occupational Therapist | Past | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Physical Therapist
- Indian Harbour Beach, FL
- NPI 1932072030
Occupational Therapist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170028800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1164568150",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5193 HIGH POINTE DR",
"city": "WINNECONNE",
"state": "WI",
"postal_code": "549868642",
"telephone_number": "920-582-4465"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3305 N BALLARD RD STE C",
"city": "APPLETON",
"state": "WI",
"postal_code": "549119001",
"telephone_number": "920-735-9234"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIES",
"first_name": "CARRIE",
"middle_name": "M",
"credential": "OTR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-29",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "WI",
"license": "2705",
"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 Jul 9, 2007; 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.