Kendall Erin Simmons, OTR/L, CLT

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

6455-26 Issued in WI

Practice address

1111 North Rd
Mauston, WI 53948-9301

Phone

(608) 847-4438

NPI assigned

Sep 22, 2021

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 2

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": "1632268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632268800000",
    "number": "1780355495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 BRANDING IRON RD",
            "city": "WEST SALEM",
            "state": "WI",
            "postal_code": "546691916",
            "telephone_number": "920-655-3686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 NORTH RD",
            "city": "MAUSTON",
            "state": "WI",
            "postal_code": "539489301",
            "telephone_number": "608-847-4438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMMONS",
        "first_name": "KENDALL",
        "middle_name": "ERIN",
        "credential": "OTR/L, CLT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-22",
        "last_updated": "2021-09-22",
        "certification_date": "2021-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "6455-26",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WI DEPARTMENT OF SAFETY AND PROFESSIONAL SERVICES",
            "identifier": "6455-26",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NATIONAL BOARD CERTIFICATION OF OCCUPATIONAL THERAPY",
            "identifier": "418517",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 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.