Active NPI
Kathleen Mary Kohlbeck, OTR
- Occupational Therapist
- Random Lake, WI
National Provider Identifier
1497937445
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 1704-026
- Practice address
- N546 Schroeter Dr
Random Lake, WI 53075-1272 - Phone
- (920) 207-3550
- Fax
- (920) 994-4606
- NPI assigned
- Dec 2, 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 | 1704-026 | WI | Primary |
Addresses
Primary practice location
N546 Schroeter Dr
Random Lake, WI 53075-1272
Mailing address
N546 Schroeter Dr
Random Lake, WI 53075-1272
Phone (920) 207-3550
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000080125 | Other | WI | GROUP PROVIDER NUMBER |
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 |
|---|---|---|---|
| 1704-026 | WI | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mueller Therapy, Inc. | Occupational Therapist | 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 and National Provider Directory roles.
-
- Occupational Therapist
- Random Lake, WI
- NPI 1578515755
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1196553600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1196553600000",
"number": "1497937445",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "N546 SCHROETER DR",
"city": "RANDOM LAKE",
"state": "WI",
"postal_code": "530751272",
"telephone_number": "920-207-3550",
"fax_number": "920-994-4606"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "N546 SCHROETER DR",
"city": "RANDOM LAKE",
"state": "WI",
"postal_code": "530751272",
"telephone_number": "920-207-3550",
"fax_number": "920-994-4606"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOHLBECK",
"first_name": "KATHLEEN",
"middle_name": "MARY",
"credential": "OTR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-12-02",
"last_updated": "2007-12-02",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "WI",
"license": "1704-026",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GROUP PROVIDER NUMBER",
"identifier": "000080125",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Random Lake, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 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.