Heather Nicole Koehlmoos, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

2076 Issued in NE

Practice address

3004 W Faidley Ave
Grand Island, NE 68803-4109

Phone

(308) 398-5170

Fax

(308) 398-5175

NPI assigned

Jul 11, 2024

Last updated

Jul 11, 2024By 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

Other names 1

• Heather Nicole Wachter Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Go Physical Therapy, LLC

  • Physical Therapist
  • Grand Island, NE
  • NPI 1184627911
  NPD

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

{
    "created_epoch": "1720656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720656000000",
    "number": "1598502130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5285",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688025285",
            "telephone_number": "308-675-1853",
            "fax_number": "308-210-4121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3004 W FAIDLEY AVE",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688034109",
            "telephone_number": "308-398-5170",
            "fax_number": "308-398-5175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOEHLMOOS",
        "first_name": "HEATHER",
        "middle_name": "NICOLE",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-11",
        "last_updated": "2024-07-11",
        "certification_date": "2024-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NE",
            "license": "2076",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HEATHER",
            "last_name": "WACHTER",
            "middle_name": "NICOLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Timothy D Knudsen, M.D.
• Nyaber Koang
• Kurt Kenneth Koch, PA-C
• Alicia Ann Kochheiser
• Richard Bruce Koefoot, M.D.
• Aldo Koentjoro, D.D.S
• Avery Kohl
• Chantal Kohl
• Rachel Sarah Kohlman, PLMHP
• Andrea Kohmetscher, APRN

• Occupational Therapist in Grand Island, NE
• Providers in Grand Island, NE by specialty
• Occupational Therapist in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2024; 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.