Kristen Suzanne Gillette, OTR/L, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2007033623 Issued in MO

Practice address

1901 E Hamilton St
Kirksville, MO 63501-3904

Phone

(660) 626-1400

Fax

(660) 665-3281

NPI assigned

Oct 30, 2007

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Miss Kristen Suzanne Shelver Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Kirksville R-III Schools

  • Local Education Agency (LEA)
  • Kirksville, MO
  • NPI 1124163662
  NPD (past)

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

{
    "created_epoch": "1193702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193702400000",
    "number": "1801075502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 E HAMILTON ST",
            "city": "KIRKSVILLE",
            "state": "MO",
            "postal_code": "635013904",
            "telephone_number": "660-626-1400",
            "fax_number": "660-665-3281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 E HAMILTON ST",
            "city": "KIRKSVILLE",
            "state": "MO",
            "postal_code": "635013904",
            "telephone_number": "660-626-1400",
            "fax_number": "660-665-3281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLETTE",
        "first_name": "KRISTEN",
        "middle_name": "SUZANNE",
        "name_prefix": "Mrs.",
        "credential": "OTR/L, DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-10-30",
        "last_updated": "2007-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MO",
            "license": "2006031899",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2007033623",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTEN",
            "last_name": "SHELVER",
            "middle_name": "SUZANNE",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Genoa Healthcare LLC
• Maura Beth Gerdes, D.O.
• Madison Geren, BCBA
• Deborah Diane Gering
• Raelene M Gilbert, LPC
• Gina R Gilliland, RNCWHNP
• Katelyn Elizabeth Glaspie, M.A., CCC-SLP
• Alyssa Golden
• Brent Gonda, DO
• Richard L Gooch, DDS

• Physical Therapist in Kirksville, MO
• Providers in Kirksville, MO by specialty
• Physical Therapist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2007; 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.