Individual provider Active NPI

Ethan Wilms, OTR/L

  • Hand Occupational Therapist
  • North Kansas City, MO
National Provider Identifier
1811798416
Registry record updated Mar 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hand Occupational TherapistTaxonomy code 225XH1200X
License
2021000498 Issued in MO
Practice address
2800 Clay Edwards Dr
North Kansas City, MO 64116-3220
Phone
(816) 691-1795
NPI assigned
Mar 20, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 20, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hand Occupational Therapist 225XH1200X 2021000498 MO Primary

Addresses

Primary practice location

2800 Clay Edwards Dr
North Kansas City, MO 64116-3220

Mailing address

1800 Walnut St Apt 409
Kansas City, MO 64108-2783
Phone (808) 640-4635

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
2021000498MOMDHand Occupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1742428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742428800000",
    "number": "1811798416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 WALNUT ST APT 409",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641082783",
            "telephone_number": "808-640-4635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 CLAY EDWARDS DR",
            "city": "NORTH KANSAS CITY",
            "state": "MO",
            "postal_code": "641163220",
            "telephone_number": "816-691-1795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILMS",
        "first_name": "ETHAN",
        "name_prefix": "Mr.",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-03-20",
        "last_updated": "2025-03-20",
        "certification_date": "2025-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": "MO",
            "license": "2021000498",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Kansas City, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2025; 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.