Kelly L McCormick, OTR/L

Primary specialty

Physical Rehabilitation Occupational TherapistTaxonomy code 225XP0019X

License

8213-26 Issued in WI

Practice address

500 Grant Ave
Omro, WI 54963-1398

Phone

(920) 685-2755

NPI assigned

Sep 7, 2023

Last updated

Sep 7, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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": "1694044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694044800000",
    "number": "1528844206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 NATURE TRAIL DR",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549561676",
            "telephone_number": "248-563-9052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 GRANT AVE",
            "city": "OMRO",
            "state": "WI",
            "postal_code": "549631398",
            "telephone_number": "920-685-2755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCORMICK",
        "first_name": "KELLY",
        "middle_name": "L",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-07",
        "last_updated": "2023-09-07",
        "certification_date": "2023-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0019X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Physical Rehabilitation",
            "state": "WI",
            "license": "8213-26",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Douglas Langeberg, RN
• Alyson P Larson, MD
• Jennie Laue, COTA/L
• Anita Lee-Bjerke
• Thomas Robert Machak, D.D.S.
• Rachel L McInnis, MS/CCC-SLP
• MDC Omro, S.C. (Dowling Dental Clinic of Omro)
• Chad Meyer, COTA
• Tina Morey, RN
• Sarah Lynn O'Connell, R.N.

• Physical Rehabilitation Occupational Therapist in Omro, WI
• Providers in Omro, WI by specialty
• Physical Rehabilitation Occupational Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2023; 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.