Kendel S Knudson, OTD, OTR/L

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

056010451 Issued in IL

Practice address

2500 W Reynolds St
Pontiac, IL 61764-9774

Phone

(815) 842-2828

NPI assigned

Dec 15, 2016

Sex

Female

Sole proprietor

No

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": "1481760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481760000000",
    "number": "1700320306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 PORTER LN",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617614215",
            "telephone_number": "815-985-0101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 W REYNOLDS ST",
            "city": "PONTIAC",
            "state": "IL",
            "postal_code": "617649774",
            "telephone_number": "815-842-2828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNUDSON",
        "first_name": "KENDEL",
        "middle_name": "S",
        "name_prefix": "Mrs.",
        "credential": "OTD, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-15",
        "last_updated": "2016-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "IL",
            "license": "056010451",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Kincinas, PA
• Kind Living Therapy, LLC
• Kianna R Klendworth, BS
• Matthew Charles Knapp, PT
• Tanya M Knauff, PT
• Mary Krall
• Samantha Kray, PSYD
• Lindsey Krzyzek, MHP
• Candace Crystal Kudla, APRN
• Jeffrey Kuska

• Pediatric Occupational Therapist in Pontiac, IL
• Providers in Pontiac, IL by specialty
• Pediatric Occupational Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 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.