Kelly Mulder, COTA

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

5045-27 Issued in WI

Practice address

138 E Prospect St
Port Washington, WI 53074

Phone

(262) 689-5265

NPI assigned

Oct 30, 2013

Sex

Female

Sole proprietor

Yes

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": "1383091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415750400000",
    "number": "1639507643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "138 E PROSPECT ST",
            "city": "PORT WASHINGTON",
            "state": "WI",
            "postal_code": "53074",
            "telephone_number": "262-689-5265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "138 E PROSPECT ST",
            "city": "PORT WASHINGTON",
            "state": "WI",
            "postal_code": "53074",
            "telephone_number": "262-689-5265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULDER",
        "first_name": "KELLY",
        "name_prefix": "Mrs.",
        "credential": "COTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-10-30",
        "last_updated": "2014-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "WI",
            "license": "5045-27",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Noel Murae Mitchell, LPC-IT, MS
• Brianna Danielle Moede, LPC
• Arleen L More O'Ferrall, APNP
• Megan Marie Morgan, CERTIFIED NURSING AS
• Erick M Muhlenbeck, LPC, CSAC, ICS
• Jeffery David Murrie
• Kathleen Noetzel, MS CCC-SLP
• NSH Port Washington LLC
• Susan Ann O'Malley-Larson, L.P.N.
• Colleen J O'Neil

• Occupational Therapy Assistant in Port Washington, WI
• Providers in Port Washington, WI by specialty
• Occupational Therapy Assistant in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2014; 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.