Kevin William Welp, COTA

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

201619 Issued in MN

Practice address

11345 Interlachen Rd
Chisago City, MN 55013-9552

Phone

(612) 398-4173

NPI assigned

Aug 4, 2010

Last updated

Oct 17, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

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": "1280880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697500800000",
    "number": "1639483480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11345 INTERLACHEN RD",
            "city": "CHISAGO CITY",
            "state": "MN",
            "postal_code": "550139552",
            "telephone_number": "612-398-4173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11345 INTERLACHEN RD",
            "city": "CHISAGO CITY",
            "state": "MN",
            "postal_code": "550139552",
            "telephone_number": "612-398-4173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELP",
        "first_name": "KEVIN",
        "middle_name": "WILLIAM",
        "name_prefix": "Mr.",
        "credential": "COTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-08-04",
        "last_updated": "2023-10-17",
        "certification_date": "2023-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "TX",
            "license": "211066",
            "primary": false
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "MN",
            "license": "201619",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Occupational Therapy Assistant in Chisago City, MN
• Providers in Chisago City, MN by specialty
• Occupational Therapy Assistant in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 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.