Individual provider Active NPI

Rebecca Susan O'Keefe, OTR

  • Pediatric Occupational Therapist
  • Menasha, WI
National Provider Identifier
1508900192
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
3606026 Issued in WI
Practice address
1800 Appleton Rd
Menasha, WI 54952-3727
Phone
(920) 968-6236
NPI assigned
Feb 16, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X 3606026 WI Primary

Addresses

Primary practice location

1800 Appleton Rd
Menasha, WI 54952-3727

Mailing address

3378 County Road F
Omro, WI 54963-9408
Phone (920) 685-0942

Other identifiers 2

IdentifierTypeStateIssuer
3606026OtherWITHERAPY LICENSE
40775200MedicaidWI

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

LicenseStateTypeSpecialty
3606026WIMDPediatric Occupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1171584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508900192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3378 COUNTY ROAD F",
            "city": "OMRO",
            "state": "WI",
            "postal_code": "549639408",
            "telephone_number": "920-685-0942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 APPLETON RD",
            "city": "MENASHA",
            "state": "WI",
            "postal_code": "549523727",
            "telephone_number": "920-968-6236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'KEEFE",
        "first_name": "REBECCA",
        "middle_name": "SUSAN",
        "name_prefix": "Ms.",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "WI",
            "license": "3606026",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "THERAPY LICENSE",
            "identifier": "3606026",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40775200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Menasha, WI

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.

Verify at the official NPI Registry.