Individual provider Active NPI

Kathleen A Dunn, OTR/L

  • Occupational Therapist
  • Ellsworth, ME
National Provider Identifier
1902903057
Registry record updated Jul 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT1326 Issued in ME
Practice address
3 Elm St Apt 1
Ellsworth, ME 04605
Phone
(207) 991-4484
NPI assigned
Sep 20, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 13, 2018

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 OT1326 ME Primary

Addresses

Primary practice location

3 Elm St Apt 1
Ellsworth, ME 04605

Mailing address

3 Elm St Apt 1
Ellsworth, ME 04605-2043
Phone (207) 991-4484

Other practice location 1

21 Alison Avenue
Ellsworth, ME 04605-3303
Phone (207) 667-9177

Other identifiers 2

IdentifierTypeStateIssuer
11315041OtherMEANTHEM
1181930004MedicaidME

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

LicenseStateTypeSpecialty
OT1326MEMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Results Physical and Occupational Therapy PastSince Jan 5, 1999 Accepting new patients
Exuberant Living, PA Occupational Therapist Past Accepting new patients
Back in Motion Physical Therapy, LLC PastSince Sep 29, 2017 Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531440000000",
    "number": "1902903057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 ELM ST APT 1",
            "city": "ELLSWORTH",
            "state": "ME",
            "postal_code": "046052043",
            "telephone_number": "207-991-4484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 ELM ST APT 1",
            "city": "ELLSWORTH",
            "state": "ME",
            "postal_code": "04605",
            "telephone_number": "207-991-4484"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "21 Alison Avenue",
            "address_purpose": "LOCATION",
            "city": "Ellsworth",
            "state": "ME",
            "postal_code": "046053303",
            "country_code": "US",
            "telephone_number": "207-667-9177",
            "fax_number": "207-667-9177",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DUNN",
        "first_name": "KATHLEEN",
        "middle_name": "A",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2018-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "ME",
            "license": "OT1326",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "11315041",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1181930004",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellsworth, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 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.

Verify at the official NPI Registry.