Individual provider Active NPI

Karen Wylie Connell, OTR, ATP

  • Pediatric Occupational Therapist
  • Temple, TX
National Provider Identifier
1407036304
Registry record updated Nov 7, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
101275 Issued in TX
Practice address
3514 Oakdale Dr
Temple, TX 76502-2350
Phone
(254) 770-0591
Fax
(254) 770-0591
NPI assigned
Nov 7, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 7, 2007

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 101275 TX
Pediatric Occupational Therapist 225XP0200X 101275 TX Primary

Addresses

Primary practice location

3514 Oakdale Dr
Temple, TX 76502-2350

Mailing address

3514 Oakdale Dr
Temple, TX 76502-2350
Phone (254) 770-0591

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
101275TXMDAmbulance

NPI Registry JSON

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

{
    "created_epoch": "1194393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194393600000",
    "number": "1407036304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3514 OAKDALE DR",
            "city": "TEMPLE",
            "state": "TX",
            "postal_code": "765022350",
            "telephone_number": "254-770-0591",
            "fax_number": "254-770-0591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3514 OAKDALE DR",
            "city": "TEMPLE",
            "state": "TX",
            "postal_code": "765022350",
            "telephone_number": "254-770-0591",
            "fax_number": "254-770-0591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNELL",
        "first_name": "KAREN",
        "middle_name": "WYLIE",
        "name_prefix": "Mrs.",
        "credential": "OTR,  ATP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-11-07",
        "last_updated": "2007-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TX",
            "license": "101275",
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "TX",
            "license": "101275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Temple, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 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.