Individual provider Active NPI

Nicole Marie Kieffer

  • Occupational Therapist
  • Belgrade, MT
National Provider Identifier
1164659199
Registry record updated Jun 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
1078 Issued in MT
Practice address
11 W Main St
Ste 218
Belgrade, MT 59714-3700
Phone
(406) 388-4988
Fax
(406) 388-6188
NPI assigned
Jun 17, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2009

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 1078 MT Primary

Addresses

Primary practice location

11 W Main St
Ste 218
Belgrade, MT 59714-3700

Mailing address

11 W Main St
Ste 218
Belgrade, MT 59714-3700
Phone (406) 388-4988

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

State licenses

LicenseStateTypeSpecialty
1078MTMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mosaic Rehabilitation Inc. Past Accepting new patients
Mosaic Rehabilitation, Inc Past Accepting new patients
Mosaic, Inc PastSince May 1, 2010 Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1245196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245196800000",
    "number": "1164659199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 W MAIN ST",
            "address_2": "STE 218",
            "city": "BELGRADE",
            "state": "MT",
            "postal_code": "597143700",
            "telephone_number": "406-388-4988",
            "fax_number": "406-388-6188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 W MAIN ST",
            "address_2": "STE 218",
            "city": "BELGRADE",
            "state": "MT",
            "postal_code": "597143700",
            "telephone_number": "406-388-4988",
            "fax_number": "406-388-6188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIEFFER",
        "first_name": "NICOLE",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-17",
        "last_updated": "2009-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MT",
            "license": "1078",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Belgrade, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2009; 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.