Active NPI
Kathryn Kiblen
- Occupational Therapist
- Windsor, CO
National Provider Identifier
1790857761
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 0005025
- Practice address
- 4650 Royal Vista Cir Ste 100
Windsor, CO 80528-9321 - Phone
- (970) 305-5070
- Fax
- (970) 541-0357
- NPI assigned
- Nov 15, 2006
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Occupational Therapist | 225XP0200X | 2001008177 | MO | |
| Pediatric Occupational Therapist | 225XP0200X | 0005025 | CO | |
| Occupational Therapist | 225X00000X | 0005025 | CO | Primary |
Addresses
Primary practice location
4650 Royal Vista Cir Ste 100
Windsor, CO 80528-9321
Mailing address
2020 Yearling Drive
Fort Collins, CO 80525-2013
Phone (913) 909-2828
Other practice location 1
607 W Lexington Ave
Independence, MO 64050-3650
Phone (816) 833-2088
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 34766013 | Other | MO | BLUE CROSS BLUE SHIELD IN |
| 475421806 | Medicaid | MO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CO
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220802000433 | CO | Practitioner - Occupational Therapist in Private Practice | 0042692428 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0005025 | CO | MD | Pediatric Occupational Therapist |
| 2001008177 | MO | MD | Pediatric Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Noco Pediatric OT, LLC | Occupational Therapist | Current | Accepting new patients |
| Noco Pediatric OT, LLC | Occupational Therapist | Current | Accepting new patients |
| Sunshine Center Inc. | Pediatrics | Past | Accepting new patients |
| Noco Pediatric OT, LLC | Occupational Therapist | Past | Accepting new patients |
Locations
1931 65th Ave
Ste C
Greeley, CO 80634
Phone (970) 352-1877
4650 Royal Vista Cir
Ste 100
Windsor, CO 80528
Phone (970) 305-5070
Organizations & group practices 4
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.
-
- Occupational Therapist
- Greeley, CO
- NPI 1043828940
-
- Occupational Therapist
- Windsor, CO
- NPI 1750726386
-
- Occupational Therapist
- Fort Collins, CO
- NPI 1841873981
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163548800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1790857761",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2020 YEARLING DRIVE",
"city": "FORT COLLINS",
"state": "CO",
"postal_code": "805252013",
"telephone_number": "913-909-2828",
"fax_number": "970-541-0357"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4650 ROYAL VISTA CIR STE 100",
"city": "WINDSOR",
"state": "CO",
"postal_code": "805289321",
"telephone_number": "970-305-5070",
"fax_number": "970-541-0357"
}
],
"practiceLocations": [
{
"address_1": "607 W Lexington Ave",
"address_purpose": "LOCATION",
"city": "Independence",
"state": "MO",
"postal_code": "640503650",
"country_code": "US",
"telephone_number": "816-833-2088",
"fax_number": "816-833-1105",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KIBLEN",
"first_name": "KATHRYN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-15",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "MO",
"license": "2001008177",
"primary": false
},
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "CO",
"license": "0005025",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "CO",
"license": "0005025",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD IN",
"identifier": "34766013",
"state": "MO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "475421806",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Windsor, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.