Patricia M. Van Den Kieboom, OTR

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

3263-026 Issued in WI

Practice address

6700 N. Port Washington Rd.
C/O St. Francis Children'S Center
Glendale, WI 53217

Phone

(414) 351-8850

Fax

(414) 351-8846

NPI assigned

Dec 30, 2005

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1135900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287619200000",
    "number": "1417934308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6700 N. PORT WASHINGTON RD.",
            "address_2": "C/O ST. FRANCIS CHILDREN'S CENTER",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "53217",
            "telephone_number": "414-351-8850",
            "fax_number": "414-351-8846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6700 N. PORT WASHINGTON RD.",
            "address_2": "C/O ST. FRANCIS CHILDREN'S CENTER",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "53217",
            "telephone_number": "414-351-8850",
            "fax_number": "414-351-8846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN DEN KIEBOOM",
        "first_name": "PATRICIA",
        "middle_name": "M.",
        "name_prefix": "Mrs.",
        "credential": "OTR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-12-30",
        "last_updated": "2010-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "3263-026",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40862700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Artie Junior Turner
• Margo Ann Turner, M.S./CCC-SLP
• Ryan Michael Ungerecht, PT, DPT
• Frank Paul Urtz, PHD
• Nicole L Valk
• Danielle Van Dyck, DPT
• Allen D Van Scoyk, D.C.
• Ilva E Van Valkenburgh, MD
• Frederick Jacobus Van Vuuren
• Choua Linda Vang

• Occupational Therapist in Glendale, WI
• Providers in Glendale, WI by specialty
• Occupational Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2010; 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.