Active NPI
Kristin Hodkiewicz
- Occupational Therapist
- Gillett, WI
National Provider Identifier
1508039983
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 3561-26
- Practice address
- 223 W Park St
Gillett, WI 54124-9414 - Phone
- (920) 855-2114
- NPI assigned
- Apr 8, 2008
- Last updated
- Aug 17, 2026
- 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 | 3561-26 | WI | Primary |
Addresses
Primary practice location
223 W Park St
Gillett, WI 54124-9414
Mailing address
223 W Park St
Gillett, WI 54124-9414
Phone (920) 855-2114
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 40902500 | Medicaid | WI | |
| 390848401050 | Other | WI | BLUE CROSS |
| 3561-26 | Other | WI | LICENSE NUMBER |
| 11014100 | Medicaid | WI | |
| 11014110 | Medicaid | WI |
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 |
|---|---|---|---|
| 3561-26 | WI | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cooperative Educational Service Agency No 8 | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Local Education Agency (LEA)
- Gillett, WI
- NPI 1699956607
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1207612800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1786924800000",
"number": "1508039983",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "223 W PARK ST",
"city": "GILLETT",
"state": "WI",
"postal_code": "541249414",
"telephone_number": "920-855-2114"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "223 W PARK ST",
"city": "GILLETT",
"state": "WI",
"postal_code": "541249414",
"telephone_number": "920-855-2114"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HODKIEWICZ",
"first_name": "KRISTIN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-04-08",
"last_updated": "2026-08-17",
"certification_date": "2026-08-17",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "WI",
"license": "3561-26",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "40902500",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "390848401050",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE NUMBER",
"identifier": "3561-26",
"state": "WI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "11014100",
"state": "WI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "11014110",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Gillett, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.