Individual provider Active NPI

Vickie Klempke

  • Occupational Therapy Assistant
  • Jefferson City, MO
National Provider Identifier
1245603372
Registry record updated Nov 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
2011001337 Issued in MO
Practice address
3218 Southwood Ter
Jefferson City, MO 65101-5913
Phone
(573) 659-0504
NPI assigned
Nov 11, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 2011001337 MO Primary
Physical Therapy Assistant 225200000X 116728 MO

Addresses

Primary practice location

3218 Southwood Ter
Jefferson City, MO 65101-5913

Mailing address

3218 Southwood Ter
Jefferson City, MO 65101-5913
Phone (573) 659-0504

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2011001337MOMDOccupational Therapy Assistant
116728MOMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1447200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447200000000",
    "number": "1245603372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3218 SOUTHWOOD TER",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651015913",
            "telephone_number": "573-659-0504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3218 SOUTHWOOD TER",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651015913",
            "telephone_number": "573-659-0504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLEMPKE",
        "first_name": "VICKIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-11",
        "last_updated": "2015-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "MO",
            "license": "2011001337",
            "primary": true
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MO",
            "license": "116728",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jefferson City, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2015; 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.