NPIMap

Individual provider Active NPI

Kathleen A Dittmar, OTR

  • Occupational Therapist
  • Germantown, WI
National Provider Identifier
1942461900
Registry record updated Jun 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
661-026 Issued in WI
Practice address
W173N10915 Bernies Way
Germantown, WI 53022-4043
Phone
(262) 509-3300
Fax
(262) 509-3338
NPI assigned
Jun 23, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2008

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 661-026 WI Primary

Addresses

Primary practice location

W173N10915 Bernies Way
Germantown, WI 53022-4043

Mailing address

W173N10915 Bernies Way
Germantown, WI 53022-4043
Phone (262) 509-3300

Other identifiers 1

IdentifierTypeStateIssuer
40541100MedicaidWI

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
661-026WIMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
NSH Summit LLC Past Accepting new patients

Organizations & group practices 1

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": "1214179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214179200000",
    "number": "1942461900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W173N10915 BERNIES WAY",
            "city": "GERMANTOWN",
            "state": "WI",
            "postal_code": "530224043",
            "telephone_number": "262-509-3300",
            "fax_number": "262-509-3338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W173N10915 BERNIES WAY",
            "city": "GERMANTOWN",
            "state": "WI",
            "postal_code": "530224043",
            "telephone_number": "262-509-3300",
            "fax_number": "262-509-3338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DITTMAR",
        "first_name": "KATHLEEN",
        "middle_name": "A",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-23",
        "last_updated": "2008-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "661-026",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40541100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Germantown, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2008; 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.