Individual provider Active NPI

Kelly Elizabeth Jones

  • Driving and Community Mobility Occupational Therapist
  • Cedarburg, WI
National Provider Identifier
1841404357
Registry record updated Aug 19, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Driving and Community Mobility Occupational TherapistTaxonomy code 225XR0403X
License
2559-026 Issued in WI
Practice address
N27W5707 Lincoln Blvd
Cedarburg, WI 53012-2852
Phone
(262) 376-7676
NPI assigned
May 10, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 19, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Driving and Community Mobility Occupational Therapist 225XR0403X 2559-026 WI Primary

Addresses

Primary practice location

N27W5707 Lincoln Blvd
Cedarburg, WI 53012-2852

Mailing address

W73N389 Greystone Dr
Cedarburg, WI 53012-2282
Phone (262) 618-2600

Other identifiers 1

IdentifierTypeStateIssuer
40776900MedicaidWI

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
2559-026WIMDDriving and Community Mobility Occupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1250640000000",
    "number": "1841404357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W73N389 GREYSTONE DR",
            "city": "CEDARBURG",
            "state": "WI",
            "postal_code": "530122282",
            "telephone_number": "262-618-2600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N27W5707 LINCOLN BLVD",
            "city": "CEDARBURG",
            "state": "WI",
            "postal_code": "530122852",
            "telephone_number": "262-376-7676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "KELLY",
        "middle_name": "ELIZABETH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-10",
        "last_updated": "2009-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XR0403X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Driving and Community Mobility",
            "state": "WI",
            "license": "2559-026",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40776900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedarburg, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2009; 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.