Individual provider Active NPI

Kristen Leigh Kosman, OTR

  • Occupational Therapist
  • Green Bay, WI
National Provider Identifier
1790917664
Registry record updated Mar 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
4656-026 Issued in WI
Practice address
1328 Reed Street
Green Bay, WI 54303
Phone
(920) 606-6142
NPI assigned
Aug 11, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2013

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 4656-026 WI Primary

Addresses

Primary practice location

1328 Reed Street
Green Bay, WI 54303

Mailing address

1328 Reed St
Green Bay, WI 54303-3106

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180214001792 WI Practitioner - Occupational Therapist in Private Practice 3779843644 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4656-026WIMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Oconto Hospital & Medical Center Inc Current Accepting new patients
Bellin Memorial Hospital Inc Current Accepting new patients
Bellin Memorial Hospital Inc Occupational Therapist CurrentSince Feb 5, 2018 Accepting new patients
Oconto Hospital & Medical Center Inc CurrentSince Feb 5, 2018 Accepting new patients
Bellin Memorial Hospital Inc CurrentSince Feb 5, 2018 Accepting new patients
Oconto Hospital & Medical Center Inc CurrentSince Feb 5, 2018 Accepting new patients

Locations

2305 San Luis Pl
Green Bay, WI 54304
Phone (920) 494-2817

744 S Webster Ave
Green Bay, WI 54301
Phone (920) 433-6025

2820 Roosevelt Rd
Marinette, WI 54143
Phone (715) 330-6171

820 Arbutus Ave
Oconto, WI 54153
Phone (920) 835-1100

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1249948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364428800000",
    "number": "1790917664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1328 REED ST",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543033106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1328 REED STREET",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "54303",
            "telephone_number": "920-606-6142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSMAN",
        "first_name": "KRISTEN",
        "middle_name": "LEIGH",
        "name_prefix": "Mrs.",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-11",
        "last_updated": "2013-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "4656-026",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2013; 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.

Verify at the official NPI Registry.