Active NPI
Kasey Wild
- Occupational Therapist
- Geneva, NY
National Provider Identifier
1932658804
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 020931-1
- Practice address
- 700 Liberty CMNS
Geneva, NY 14456-2064 - Phone
- (315) 789-0691
- NPI assigned
- Oct 3, 2016
- 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 | 020931-1 | NY | Primary |
Addresses
Primary practice location
700 Liberty CMNS
Geneva, NY 14456-2064
Mailing address
4161 Middle Rd
Canandaigua, NY 14424-8311
Phone (585) 506-8496
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 |
|---|---|---|---|
| 020931-1 | NY | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1475452800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1475452800000",
"number": "1932658804",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4161 MIDDLE RD",
"city": "CANANDAIGUA",
"state": "NY",
"postal_code": "144248311",
"telephone_number": "585-506-8496"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "700 LIBERTY CMNS",
"city": "GENEVA",
"state": "NY",
"postal_code": "144562064",
"telephone_number": "315-789-0691"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILD",
"first_name": "KASEY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-10-03",
"last_updated": "2016-10-03",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NY",
"license": "020931-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Geneva, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.