Individual provider Active NPI

Colby Clay Nuessen, OTR

  • Occupational Therapist
  • Kansas City, MO
National Provider Identifier
1619575644
Registry record updated Oct 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
2020026792 Issued in MO
Practice address
9411 N Oak Trfy
Kansas City, MO 64155-2233
Phone
(816) 436-6383
Fax
(816) 436-8143
NPI assigned
Oct 12, 2020
Last updated
Oct 12, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 17-03734 KS
Occupational Therapist 225X00000X 2020026792 MO Primary

Addresses

Primary practice location

9411 N Oak Trfy
Kansas City, MO 64155-2233

Mailing address

7200 N Delta Ave
Kansas City, MO 64151-2211
Phone (620) 412-3578

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

LicenseStateTypeSpecialty
17-03734KSMDOccupational Therapist
2020026792MOMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1602460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602460800000",
    "number": "1619575644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7200 N DELTA AVE",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641512211",
            "telephone_number": "620-412-3578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9411 N OAK TRFY",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641552233",
            "telephone_number": "816-436-6383",
            "fax_number": "816-436-8143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUESSEN",
        "first_name": "COLBY",
        "middle_name": "CLAY",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-10-12",
        "last_updated": "2020-10-12",
        "certification_date": "2020-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "KS",
            "license": "17-03734",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MO",
            "license": "2020026792",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2020; 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.