Individual provider Active NPI

Karen Elizabeth Willems

  • Occupational Therapist
  • Monona, WI
National Provider Identifier
1770694564
Registry record updated Apr 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
2978-26 Issued in WI
Practice address
1050 East Broadway
Compliance Mail Code 9199
Monona, WI 53716
Phone
(608) 890-6110
NPI assigned
Aug 31, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 14, 2021

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 2978-26 WI Primary

Addresses

Primary practice location

1050 East Broadway
Compliance Mail Code 9199
Monona, WI 53716

Mailing address

1050 East Broadway
Compliance Mail Code 9199
Monona, WI 53716
Phone (608) 890-6110

Other practice location 1

600 Highland Ave
Compliance Mail Code 2433
Madison, WI 53792-0001
Phone (608) 662-0817

Other identifiers 1

IdentifierTypeStateIssuer
2978-26OtherWIOCCUPATIONAL THERAPY

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
2978-26WIMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618358400000",
    "number": "1770694564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 EAST BROADWAY",
            "address_2": "COMPLIANCE MAIL CODE 9199",
            "city": "MONONA",
            "state": "WI",
            "postal_code": "53716",
            "telephone_number": "608-890-6110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 EAST BROADWAY",
            "address_2": "COMPLIANCE MAIL CODE 9199",
            "city": "MONONA",
            "state": "WI",
            "postal_code": "53716",
            "telephone_number": "608-890-6110"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 Highland Ave",
            "address_2": "Compliance Mail Code 2433",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "WI",
            "postal_code": "537920001",
            "country_code": "US",
            "telephone_number": "608-662-0817",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLEMS",
        "first_name": "KAREN",
        "middle_name": "ELIZABETH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2021-04-14",
        "certification_date": "2021-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "2978-26",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OCCUPATIONAL THERAPY",
            "identifier": "2978-26",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Monona, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2021; 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.