Dusty R Kaesberg, COTA

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

057002965 Issued in IL

Practice address

11093 N Prairie Rd
Red Bud, IL 62278-4372

Phone

(618) 910-1382

NPI assigned

Oct 31, 2008

Last updated

Oct 31, 2008By the provider in NPPES

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

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": "1225411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225411200000",
    "number": "1508019787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11093 N PRAIRIE RD",
            "city": "RED BUD",
            "state": "IL",
            "postal_code": "622784372",
            "telephone_number": "618-910-1382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11093 N PRAIRIE RD",
            "city": "RED BUD",
            "state": "IL",
            "postal_code": "622784372",
            "telephone_number": "618-910-1382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAESBERG",
        "first_name": "DUSTY",
        "middle_name": "R",
        "credential": "COTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-31",
        "last_updated": "2008-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "IL",
            "license": "057002965",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Occupational Therapy Assistant in Red Bud, IL
• Providers in Red Bud, IL by specialty
• Occupational Therapy Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2008; 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.