Active NPI
Kylee Kuecker, OTR/L
- Occupational Therapist
- Knob Noster, MO
National Provider Identifier
1649956855
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 2023019683
- Practice address
- 1800 W Irish LN
Knob Noster, MO 65336-1020 - Phone
- (660) 687-0187
- Fax
- (660) 687-0221
- NPI assigned
- Jun 22, 2023
- Last updated
- Jun 22, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 2023019683 | MO | Primary |
Addresses
Primary practice location
1800 W Irish LN
Knob Noster, MO 65336-1020
Mailing address
19699 Aspen Ave
Blackburn, MO 65321-2321
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2023019683 | MO | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pediatric Place, LLC | Occupational Therapist | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1687392000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687392000000",
"number": "1649956855",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19699 ASPEN AVE",
"city": "BLACKBURN",
"state": "MO",
"postal_code": "653212321"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1800 W IRISH LN",
"city": "KNOB NOSTER",
"state": "MO",
"postal_code": "653361020",
"telephone_number": "660-687-0187",
"fax_number": "660-687-0221"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KUECKER",
"first_name": "KYLEE",
"credential": "OTR/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-06-22",
"last_updated": "2023-06-22",
"certification_date": "2023-06-22",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MO",
"license": "2023019683",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Knob Noster, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 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.