Active NPI
Kelly Susan Wunderly, OTR
- Occupational Therapist
- Indianapolis, IN
National Provider Identifier
1811150287
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 31003781A
- Practice address
- 5226 E 82ND St
Indianapolis, IN 46250-1628 - Phone
- (317) 842-6668
- Fax
- (317) 578-4113
- NPI assigned
- Jul 7, 2008
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 31003781A | IN | Primary |
Addresses
Primary practice location
5226 E 82ND St
Indianapolis, IN 46250-1628
Mailing address
8158 Birchfield Dr
Indianapolis, IN 46268-2895
Phone (317) 709-1610
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 31003781A | IN | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1215388800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1516579200000",
"number": "1811150287",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8158 BIRCHFIELD DR",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462682895",
"telephone_number": "317-709-1610"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5226 E 82ND ST",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462501628",
"telephone_number": "317-842-6668",
"fax_number": "317-578-4113"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WUNDERLY",
"first_name": "KELLY",
"middle_name": "SUSAN",
"name_prefix": "Mrs.",
"credential": "OTR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-07-07",
"last_updated": "2018-01-22",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "IN",
"license": "31003781A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.