Individual provider Active NPI

Shellie Lynn Keisling

  • Occupational Therapist
  • Madison, WI
National Provider Identifier
1811066376
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
2142-26 Issued in WI
Practice address
600 Highland Ave
Compliance Mail Code 2433
Madison, WI 53792-0001
Phone
(608) 662-0817
NPI assigned
Nov 7, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 2142-26 WI Primary

Addresses

Primary practice location

600 Highland Ave
Compliance Mail Code 2433
Madison, WI 53792-0001

Mailing address

600 Highland Ave
Compliance Mail Code 2433
Madison, WI 53792-0001
Phone (608) 662-0817

Other identifiers 1

IdentifierTypeStateIssuer
2142-26OtherWIOCCUPATIONAL THERAPY

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

LicenseStateTypeSpecialty
2142-26WIMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1811066376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 HIGHLAND AVE",
            "address_2": "COMPLIANCE MAIL CODE 2433",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537920001",
            "telephone_number": "608-662-0817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 HIGHLAND AVE",
            "address_2": "COMPLIANCE MAIL CODE 2433",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537920001",
            "telephone_number": "608-662-0817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEISLING",
        "first_name": "SHELLIE",
        "middle_name": "LYNN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "2142-26",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OCCUPATIONAL THERAPY",
            "identifier": "2142-26",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.