Individual provider Active NPI

Theresa Louise Kiefer, COTA

  • Occupational Therapy Assistant
  • Elkhart, IN
National Provider Identifier
1295933570
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
32001166A Issued in IN
Practice address
2600 Morehouse Ave
Elkhart, IN 46517-2552
Phone
(574) 295-8800
NPI assigned
Jul 6, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 32001166A IN Primary

Addresses

Primary practice location

2600 Morehouse Ave
Elkhart, IN 46517-2552

Mailing address

57773 Newman St
Elkhart, IN 46516-5901

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
32001166AINMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1183680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295933570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "57773 NEWMAN ST",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465165901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 MOREHOUSE AVE",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465172552",
            "telephone_number": "574-295-8800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIEFER",
        "first_name": "THERESA",
        "middle_name": "LOUISE",
        "credential": "COTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "IN",
            "license": "32001166A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkhart, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.