Kidmotion: Brenda Chilstrom, Pediatric Occupational Therapy, LLC

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

9691 Issued in FL

Legal business name

KIDMOTION: BRENDA CHILSTROM, PEDIATRIC OCCUPATIONAL THERAPY, LLC

Practice address

15541 Marcello Cir
Naples, FL 34110-2836

Phone

(239) 595-7018

Fax

(239) 495-1792

NPI assigned

Dec 11, 2014

Organization subpart

No

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

Authorized official

Name

Brenda Chilstrom, OTR/L

Title

Owner

Phone

(239) 595-7018

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• KidMotion Other name

Tax ID family

Kidmotion2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Kidmotion Brenda Chilstrom Pediatric Occupational Therapist LLC

  • Occupational Therapist
  • Naples, FL
  • NPI 1366638975
  NPD tax ID

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

{
    "created_epoch": "1418256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1418256000000",
    "number": "1881092674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15541 MARCELLO CIR",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341102836",
            "telephone_number": "239-595-7018",
            "fax_number": "239-495-1792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15541 MARCELLO CIR",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341102836",
            "telephone_number": "239-595-7018",
            "fax_number": "239-495-1792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDMOTION: BRENDA CHILSTROM, PEDIATRIC OCCUPATIONAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-11",
        "last_updated": "2014-12-11",
        "status": "A",
        "authorized_official_last_name": "CHILSTROM",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "239-595-7018",
        "authorized_official_credential": "OTR/L"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "FL",
            "license": "9691",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "886061100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD PROVIDER NUMBER",
            "identifier": "Z9456",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "KidMotion",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Diane Elizabeth Kibiloski, PA-C
• Eshan Malik Kibria, DO
• Sean M. Kibria, DPM
• Brandy Michelle Kidd, M.S.W., L.C.S.W.
• Kidmotion Brenda Chilstrom Pediatric Occupational Therapist LLC
• Kidney Institute of Naples, LLC
• Kids First Pediatric Center
• Kids R Kids Therapy, LLC
• Kids Solutions Inc
• Kidz Medical Services

• Pediatric Occupational Therapist in Naples, FL
• Providers in Naples, FL by specialty
• Pediatric Occupational Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2014; 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.