Active NPI
Kealy A Hootman, LPT
- Physical Rehabilitation Occupational Therapist
- Rockford, IL
National Provider Identifier
1265765937
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Rehabilitation Occupational Therapist
- License
- 070014723
- Practice address
- 5100 E State St
Ste 200
Rockford, IL 61108-2913 - Phone
- (815) 637-2200
- Fax
- (815) 637-2900
- NPI assigned
- Sep 14, 2009
- 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 |
|---|---|---|---|---|
| Physical Rehabilitation Occupational Therapist | 225XP0019X | 070014723 | IL | Primary |
Addresses
Primary practice location
5100 E State St
Ste 200
Rockford, IL 61108-2913
Mailing address
5100 E State St
Ste 200
Rockford, IL 61108-2913
Phone (815) 637-2200
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 070014723 | Other | IL | LICENSED PHYSICAL THERAPIST |
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Transitions Hospice LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Community Based Hospice Care Agency
- Elk Grove Village, IL
- NPI 1063694388
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1252886400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1252886400000",
"number": "1265765937",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5100 E STATE ST",
"address_2": "STE 200",
"city": "ROCKFORD",
"state": "IL",
"postal_code": "611082913",
"telephone_number": "815-637-2200",
"fax_number": "815-637-2900"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5100 E STATE ST",
"address_2": "STE 200",
"city": "ROCKFORD",
"state": "IL",
"postal_code": "611082913",
"telephone_number": "815-637-2200",
"fax_number": "815-637-2900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOOTMAN",
"first_name": "KEALY",
"middle_name": "A",
"credential": "LPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-09-14",
"last_updated": "2009-09-14",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0019X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Physical Rehabilitation",
"state": "IL",
"license": "070014723",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSED PHYSICAL THERAPIST",
"identifier": "070014723",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Rockford, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 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.