Individual provider Active NPI

Kimberly Goettl, OT

  • Pediatric Occupational Therapist
  • Hudson, WI
National Provider Identifier
1285043414
Registry record updated Aug 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
6565-26 Issued in WI
Practice address
1350 Carmichael Rd
Hudson, WI 54016-8322
Phone
(715) 377-3703
NPI assigned
Aug 13, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 104727 MN
Pediatric Occupational Therapist 225XP0200X 6565-26 WI Primary

Addresses

Primary practice location

1350 Carmichael Rd
Hudson, WI 54016-8322

Mailing address

73 Lockwood CT
Hudson, WI 54016-7743
Phone (715) 308-1494

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
104727MNMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1407888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787702400000",
    "number": "1285043414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "73 LOCKWOOD CT",
            "city": "HUDSON",
            "state": "WI",
            "postal_code": "540167743",
            "telephone_number": "715-308-1494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 CARMICHAEL RD",
            "city": "HUDSON",
            "state": "WI",
            "postal_code": "540168322",
            "telephone_number": "715-377-3703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOETTL",
        "first_name": "KIMBERLY",
        "credential": "OT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-08-13",
        "last_updated": "2026-08-26",
        "certification_date": "2026-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MN",
            "license": "104727",
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "WI",
            "license": "6565-26",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hudson, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2026; 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.