Individual provider Active NPI

Julie Kindervater Maclellan, MSOTRL

  • Occupational Therapist
  • Milwaukee, WI
National Provider Identifier
1699222521
Registry record updated Dec 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
578326 Issued in WI
Practice address
2901 W Kinnickinnic River Pkwy
Suite 500
Milwaukee, WI 53215-3677
Phone
(414) 649-3250
NPI assigned
Sep 8, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 578326 WI Primary

Addresses

Primary practice location

2901 W Kinnickinnic River Pkwy
Suite 500
Milwaukee, WI 53215-3677

Mailing address

2901 W Kinnickinnic River Pkwy
Suite 500
Milwaukee, WI 53215-3677
Phone (414) 649-3250

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
578326WIMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1473292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481155200000",
    "number": "1699222521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2901 W KINNICKINNIC RIVER PKWY",
            "address_2": "SUITE 500",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532153677",
            "telephone_number": "414-649-3250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 W KINNICKINNIC RIVER PKWY",
            "address_2": "SUITE 500",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532153677",
            "telephone_number": "414-649-3250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACLELLAN",
        "first_name": "JULIE",
        "middle_name": "KINDERVATER",
        "credential": "MSOTRL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-08",
        "last_updated": "2016-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "578326",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2016; 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.