Individual provider Active NPI

Kimberly K Swanson, OTR

  • Occupational Therapist
  • Fon Du Lac, WI
National Provider Identifier
1750539730
Registry record updated Mar 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
1624-026 Issued in WI
Practice address
845 S Main Street
Suite 120
Fon Du Lac, WI 54935
Phone
(920) 322-0447
Fax
(920) 322-1362
NPI assigned
Sep 3, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2012

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 1624-026 WI Primary

Addresses

Primary practice location

845 S Main Street
Suite 120
Fon Du Lac, WI 54935

Mailing address

845 S Main Street
Suite 120
Fon Du Lac, WI 54935
Phone (920) 322-0447

Other names 1

  • Kimberly S Wier Former name

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
1624-026WIMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Rehab Arisces Home Health Services Past Accepting new patients
Taylored Rehab, LLC Occupational Therapist Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1220400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330560000000",
    "number": "1750539730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "845 S MAIN STREET",
            "address_2": "SUITE 120",
            "city": "FON DU LAC",
            "state": "WI",
            "postal_code": "54935",
            "telephone_number": "920-322-0447",
            "fax_number": "920-322-1362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "845 S MAIN STREET",
            "address_2": "SUITE 120",
            "city": "FON DU LAC",
            "state": "WI",
            "postal_code": "54935",
            "telephone_number": "920-322-0447",
            "fax_number": "920-322-1362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWANSON",
        "first_name": "KIMBERLY",
        "middle_name": "K",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-03",
        "last_updated": "2012-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "1624-026",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "WIER",
            "middle_name": "S",
            "credential": "OTR",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fon Du Lac, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2012; 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.