Kris A Moeller, OTR

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

3720-26 Issued in WI

Practice address

317 Knutson Dr
Madison, WI 53704-1133

Phone

(608) 301-9378

Fax

(608) 301-9388

NPI assigned

Jun 20, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Kris A Eichstaedt Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1497916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1174043392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "317 KNUTSON DR",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537041133",
            "telephone_number": "608-301-9378",
            "fax_number": "608-301-9388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "317 KNUTSON DR",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537041133",
            "telephone_number": "608-301-9378",
            "fax_number": "608-301-9388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOELLER",
        "first_name": "KRIS",
        "middle_name": "A",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-20",
        "last_updated": "2022-07-21",
        "certification_date": "2021-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "3720-26",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40849300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRIS",
            "last_name": "EICHSTAEDT",
            "middle_name": "A",
            "credential": "OTR",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kaia Kristine Moe, PA-C
• Pamela Lorraine Moe, OTR
• Karyn Evelyn Moehring, MA, RDN, CD
• Alexander Robert Moeller, MD
• Barbara Ann Moeller, OTR
• Jessica Lee Moelling, PHARM D.
• Deborah Y Moen, LCSW
• Gabrielle Neilson Moen, DDS
• Jodi Moen, LPC
• Lindsey Moffatt

• Occupational Therapist in Madison, WI
• Providers in Madison, WI by specialty
• Occupational Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.