Kelly Marie Widule, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

6214-26 Issued in WI

Practice address

2705 Enloe St
Hudson, WI 54016-8173

Phone

(715) 690-2600

NPI assigned

Feb 21, 2018

Last updated

Oct 2, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Points of Stillness LLC

  • Specialist
  • Hudson, WI
  • NPI 1841516713
  Medicare reassignment NPD

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

{
    "created_epoch": "1519171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696204800000",
    "number": "1720589161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N8051 925TH ST",
            "city": "RIVER FALLS",
            "state": "WI",
            "postal_code": "540224437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2705 ENLOE ST",
            "city": "HUDSON",
            "state": "WI",
            "postal_code": "540168173",
            "telephone_number": "715-690-2600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIDULE",
        "first_name": "KELLY",
        "middle_name": "MARIE",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-21",
        "last_updated": "2023-10-02",
        "certification_date": "2023-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "6214-26",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Western Wisconsin Medical Associates Hudson LTD (Hudson Physicians)
• Tamara Lynn Wettstein
• Shelly Dee Weyers, LPN
• Brian M. Whisler
• Charles Wiatr
• Heather Wilford, MS, BCBA
• Brittany Lee Willard, RD, LD
• Caroline Kay Williamson, OTR L
• Michael John Winters, DO
• Wisconsin CVS Pharmacy LLC (CVS Pharmacy #16589)

• Occupational Therapist in Hudson, WI
• Providers in Hudson, WI by specialty
• Occupational Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.