Hugo Dahlstrom
Individual provider Active NPI Occupational Therapist · Fort Scott, KS
NPI 1578038907 · NPPES record last updated Oct 12, 2018
Key facts
- NPI
- 1578038907
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapist 225X00000X
- License
- 17-02686 (KS)
- Practice address
- 405 Woodland Hills Blvd
Fort Scott, KS 66701-8799 - Phone
- (620) 223-7073
- NPI assigned
- Oct 12, 2018
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Occupational Therapist in Private Practice
- Education
- University of Kansas School of Med (KC/Wich/Sal), 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- I Am Rehab LLC
Practice addresses (Care Compare)
405 Woodland Hills Blvd
Fort Scott, KS 66701-8799
Phone (620) 223-7073
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KS
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190319001909 | KS | Practitioner - Occupational Therapist in Private Practice | 2961742507 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17-02686 | KS | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| I Am Rehab LLC | Occupational Therapist | Current |
Accepting new patients |
Locations
405 Woodland Hills Blvd
Fort Scott, KS 66701
Phone (620) 223-3800
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 17-02686 | KS | Yes |
Addresses
Primary practice location
405 Woodland Hills Blvd
Fort Scott, KS 66701-8799
Mailing address
13943 W 150TH Ter
Olathe, KS 66062-3326
Other providers in Fort Scott, KS
- County of Bourbon
- Crank Chiropractic Care Inc
- Erin M Crank
- Crawford Dental
- Haley Crupper
- Paul Lee Daniels
- Steven Davidson
- Heather Catherine Davis
- Donna Dewey
- Whitney Anne Dickerson
All providers in Fort Scott, KS · Occupational Therapist in Kansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 12, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.