Wauwatosa Therapies LLC

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

4408-26 Issued in WI

Legal business name

WAUWATOSA THERAPIES LLC

Practice address

515 North Glenview Avenue
Wauwatosa, WI 53213-3234

Phone

(414) 763-6996

Fax

(414) 221-0057

NPI assigned

Jul 14, 2010

Organization subpart

No

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

Authorized official

Name

Mrs. Jennifer Lynn Kebbekus, MS, OTRNPI 1467546002

Title

Owner

Phone

(414) 763-6996

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jennifer Lynn Kebbekus, MS, OTR

  • Occupational Therapist
  • Wauwatosa, WI
  • NPI 1467546002
  NPD (past) Authorized official

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

{
    "created_epoch": "1279065600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1279065600000",
    "number": "1700198124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2473 NORTH 60TH STREET",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532102222",
            "telephone_number": "414-763-6996",
            "fax_number": "414-221-0057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 NORTH GLENVIEW AVENUE",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532133234",
            "telephone_number": "414-763-6996",
            "fax_number": "414-221-0057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAUWATOSA THERAPIES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-14",
        "last_updated": "2010-07-14",
        "status": "A",
        "authorized_official_last_name": "KEBBEKUS",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "414-763-6996",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MS, OTR"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "WI",
            "license": "4408-26",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pediatric Occupational Therapist in Wauwatosa, WI
• Providers in Wauwatosa, WI by specialty
• Pediatric Occupational Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2010; 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.