Individual provider Active NPI

Kelly Nicole Dornbier, MOTR/L

  • Pediatric Occupational Therapist
  • Casper, WY
National Provider Identifier
1689115669
Registry record updated Mar 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
OTR-1017 Issued in WY
Practice address
2020 E 12TH St
Casper, WY 82601-4007
Phone
(307) 235-5097
NPI assigned
Mar 10, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Rehabilitation Occupational Therapist 225XP0019X OTR-1017 WY
Pediatric Occupational Therapist 225XP0200X OTR-1017 WY Primary

Addresses

Primary practice location

2020 E 12TH St
Casper, WY 82601-4007

Mailing address

2020 E 12TH St
Casper, WY 82601-4007
Phone (307) 235-5097

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)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1489104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489104000000",
    "number": "1689115669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 E 12TH ST",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826014007",
            "telephone_number": "307-235-5097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 E 12TH ST",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826014007",
            "telephone_number": "307-235-5097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORNBIER",
        "first_name": "KELLY",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "MOTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-10",
        "last_updated": "2017-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0019X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Physical Rehabilitation",
            "state": "WY",
            "license": "OTR-1017",
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "WY",
            "license": "OTR-1017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Casper, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2017; 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.