Katie Fiona Jerdee, COTA

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

1921-027 Issued in WI

Practice address

3205 Wood Rd
Racine, WI 53406-5048

Phone

(126) 259-8914

NPI assigned

Oct 7, 2008

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

Other identifiers 1

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": "1223337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1223337600000",
    "number": "1760633937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "806 MADISON AVE",
            "city": "SOUTH MILWAUKEE",
            "state": "WI",
            "postal_code": "531722622",
            "telephone_number": "414-764-3628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3205 WOOD RD",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534065048",
            "telephone_number": "126-259-8914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JERDEE",
        "first_name": "KATIE",
        "middle_name": "FIONA",
        "name_prefix": "Mrs.",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-07",
        "last_updated": "2008-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "WI",
            "license": "1921-027",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID PROGRAM NON BILLING PROVIDER NUMBER",
            "identifier": "40892500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lorice Jean
• Jill Jelinek, L.AC.
• Jodi Mari Jensen, L.B.T.
• Marianne T. Jensen, MSW
• Cara Jerdee
• Jewel Food Stores Inc
• Tracy Rae Johanneck-Utphall, COTA
• John T. Dembowiak, LPT, S.C.
• Rosamma T John, APNP
• Johnson Furniture3 Inc

• Occupational Therapy Assistant in Racine, WI
• Providers in Racine, WI by specialty
• Occupational Therapy Assistant in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2008; 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.