Individual provider Active NPI

Connor Patrick O'Keefe

  • Occupational Therapist
  • Sussex, WI
National Provider Identifier
1174396824
Registry record updated Nov 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
8432-26 Issued in WI
Practice address
W235N6350 Hickory Dr
Sussex, WI 53089-1152
Phone
(262) 932-2800
NPI assigned
Nov 3, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 3, 2023

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 8432-26 WI Primary

Addresses

Primary practice location

W235N6350 Hickory Dr
Sussex, WI 53089-1152

Mailing address

3970 Oregon St Unit 5
Oshkosh, WI 54902-7137
Phone (920) 527-1642

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241028000298 WI Practitioner - Occupational Therapist in Private Practice 2961935184 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sundance Rehabilitation LLCGroup PAC ID 7911815329, 20 clinicians
Oasis Therapy Services LLCGroup PAC ID 8325427974, 73 clinicians

Practice addresses (Care Compare)

6109 Braun Rd
Mount Pleasant, WI 53403-9409
Phone (262) 977-6726

631 Hazel St
Oshkosh, WI 54901-4600
Phone (920) 393-9998

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sundance Rehabilitation LLC CurrentSince Aug 18, 2024 Accepting new patients
Oasis Therapy Services LLC Occupational Therapist CurrentSince Sep 30, 2025 Accepting new patients
Powerback Rehabilitation LLC Occupational Therapist PastSince Nov 5, 2023 Accepting new patients

Locations

8170 McCormick Blvd
Ste 112
Skokie, IL 60076
Phone (920) 252-4442

6109 Braun Rd
Mount Pleasant, WI 53403
Phone (262) 484-4724

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1698969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1174396824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3970 OREGON ST UNIT 5",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549027137",
            "telephone_number": "920-527-1642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W235N6350 HICKORY DR",
            "city": "SUSSEX",
            "state": "WI",
            "postal_code": "530891152",
            "telephone_number": "262-932-2800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'KEEFE",
        "first_name": "CONNOR",
        "middle_name": "PATRICK",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-11-03",
        "last_updated": "2023-11-03",
        "certification_date": "2023-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "8432-26",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sussex, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2023; 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.