Active NPI
Jennifer Depies, OTR
- Occupational Therapist
- Kaukauna, WI
National Provider Identifier
1770908279
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 5448-26
- Practice address
- 316 E 14TH St
Kaukauna, WI 54130-3304 - Phone
- (920) 766-6020
- NPI assigned
- Feb 20, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 5448-26 | WI | Primary |
Addresses
Primary practice location
316 E 14TH St
Kaukauna, WI 54130-3304
Mailing address
2104 Hickory LN
New Holstein, WI 53061-1502
Other names 1
- Jennifer Timm
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
| License | State | Type | Specialty |
|---|---|---|---|
| 5448-26 | WI | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1392854400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1392854400000",
"number": "1770908279",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2104 HICKORY LN",
"city": "NEW HOLSTEIN",
"state": "WI",
"postal_code": "530611502"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "316 E 14TH ST",
"city": "KAUKAUNA",
"state": "WI",
"postal_code": "541303304",
"telephone_number": "920-766-6020"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEPIES",
"first_name": "JENNIFER",
"credential": "OTR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-02-20",
"last_updated": "2014-02-20",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "WI",
"license": "5448-26",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JENNIFER",
"last_name": "TIMM",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Kaukauna, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.