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Organization Active NPI

Kidmotion Brenda Chilstrom Pediatric Occupational Therapist LLC

  • Occupational Therapist
  • Naples, FL
National Provider Identifier
1366638975
Registry record updated Sep 18, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT9691 Issued in FL
Legal business name
KIDMOTION BRENDA CHILSTROM PEDIATRIC OCCUPATIONAL THERAPIST LLC
Practice address
102 Pebble Shores Drive
#202
Naples, FL 34110
Phone
(239) 595-7018
Fax
(239) 597-3287
NPI assigned
Sep 18, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2007

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

Authorized official

Name
Brenda Chilstrom, OTRL
Title
Occupational Therapist
Phone
(239) 595-7018

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225X00000X OT9691 FL Primary

Addresses

Primary practice location

102 Pebble Shores Drive
#202
Naples, FL 34110

Mailing address

PO Box 111896
Naples, FL 34108
Phone (239) 595-7018

Other names 1

  • KidMotion Other name

National Provider Directory

National Provider Directory
Tax ID family
Kidmotion2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1190073600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190073600000",
    "number": "1366638975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 111896",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "34108",
            "telephone_number": "239-595-7018",
            "fax_number": "239-597-3287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 PEBBLE SHORES DRIVE",
            "address_2": "#202",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "34110",
            "telephone_number": "239-595-7018",
            "fax_number": "239-597-3287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDMOTION BRENDA CHILSTROM PEDIATRIC OCCUPATIONAL THERAPIST LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-18",
        "last_updated": "2007-09-18",
        "status": "A",
        "authorized_official_last_name": "CHILSTROM",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_title_or_position": "OCCUPATIONAL THERAPIST",
        "authorized_official_telephone_number": "239-595-7018",
        "authorized_official_credential": "OTRL"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT9691",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "KidMotion",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Naples, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 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.