Active NPI
Kim C Heiskell, OTR
- Occupational Therapist
- Clearwater, KS
National Provider Identifier
1396876504
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 17-01565
- Practice address
- 620 E. Wood
Clearwater, KS 67026-9757 - Phone
- (620) 584-4542
- NPI assigned
- Mar 8, 2007
- Last updated
- Jul 8, 2007
- 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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 17-01565 | KS | Primary |
Addresses
Primary practice location
620 E. Wood
Clearwater, KS 67026-9757
Mailing address
13303 SW 210TH
Douglass, KS 67039
Phone (316) 747-2859
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
| License | State | Type | Specialty |
|---|---|---|---|
| 17-01565 | KS | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lighthouse Rehabilitation 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Skilled Nursing Facility
- Clearwater, KS
- NPI 1861523086
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173312000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1396876504",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13303 SW 210TH",
"city": "DOUGLASS",
"state": "KS",
"postal_code": "67039",
"telephone_number": "316-747-2859"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "620 E. WOOD",
"city": "CLEARWATER",
"state": "KS",
"postal_code": "670269757",
"telephone_number": "620-584-4542"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HEISKELL",
"first_name": "KIM",
"middle_name": "C",
"credential": "OTR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-08",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "KS",
"license": "17-01565",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clearwater, KS
- Clearwater Retirement Community Inc. (CRC The Manor)
- Cindy Davidson, SLP
- Charisse C Frisch, DDS
- Gracemed Health Clinic, Inc (GraceMed Clearwater Family Clinic)
- Richard Grizzle, EMT
- Veronica Herrera
- Elizabeth Ann House, PHYSICAL THERAPIST
- Lighthouse Rehabilitation LLC
- Carol Manes, RN
- Karl L May, D.C.
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.