Active NPI
Kay Alborn Weller, DT
- Developmental Therapist
- Palmyra, IL
National Provider Identifier
1497977623
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Developmental Therapist
- License
- KW03100205P
- Practice address
- 30746 Robin Rd
Palmyra, IL 62674-6644 - Phone
- (217) 484-6308
- NPI assigned
- May 3, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Developmental Therapist | 222Q00000X | KW03100205P | IL | Primary |
Addresses
Primary practice location
30746 Robin Rd
Palmyra, IL 62674-6644
Mailing address
30746 Robin Rd
Palmyra, IL 62674-6644
Phone (217) 484-6308
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| KW03100205P | IL | MD | Developmental Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178150400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1497977623",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30746 ROBIN RD",
"city": "PALMYRA",
"state": "IL",
"postal_code": "626746644",
"telephone_number": "217-484-6308"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30746 ROBIN RD",
"city": "PALMYRA",
"state": "IL",
"postal_code": "626746644",
"telephone_number": "217-484-6308"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WELLER",
"first_name": "KAY",
"middle_name": "ALBORN",
"name_prefix": "Mrs.",
"credential": "DT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-03",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "222Q00000X",
"taxonomy_group": "",
"desc": "Developmental Therapist",
"state": "IL",
"license": "KW03100205P",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Palmyra, IL
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.