Individual provider Active NPI

Karen Patricia Boutiette, OTR

  • Occupational Therapist
  • Eau Claire, WI
National Provider Identifier
1962614859
Registry record updated Dec 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
3049-026 Issued in WI
Practice address
733 W Clairemont Ave
Eau Claire, WI 54701-6101
Phone
(715) 838-5222
NPI assigned
May 4, 2007
Last updated
Dec 3, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2024

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 3049-026 WI Primary

Addresses

Primary practice location

733 W Clairemont Ave
Eau Claire, WI 54701-6101

Mailing address

PO Box 860912
Minneapolis, MN 55486-0912
Phone (715) 838-5222

Other practice location 1

1405 Truax Blvd
Eau Claire, WI 54703-1474
Phone (715) 552-1030

Other practice location 2

1405 Truax Blvd
Eau Claire, WI 54703-1474
Phone (715) 552-1030

Other practice location 3

1221 Whipple St
Eau Claire, WI 54703
Phone (715) 838-5222

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kboutiette21793@ehrdirect.mayoclinicmsg.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160517001412 WI Practitioner - Occupational Therapist in Private Practice 3678862505 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3049-026WIMDOccupational Therapist

Interoperability endpoints

  • Direct secure messaging: kboutiette21793@ehrdirect.mayoclinicmsg.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733184000000",
    "number": "1962614859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 860912",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554860912",
            "telephone_number": "715-838-5222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "733 W CLAIREMONT AVE",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547016101",
            "telephone_number": "715-838-5222"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1405 Truax Blvd",
            "address_purpose": "LOCATION",
            "city": "Eau Claire",
            "state": "WI",
            "postal_code": "547031474",
            "country_code": "US",
            "telephone_number": "715-552-1030",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1405 Truax Blvd",
            "address_purpose": "LOCATION",
            "city": "Eau Claire",
            "state": "WI",
            "postal_code": "547031474",
            "country_code": "US",
            "telephone_number": "715-552-1030",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1221 Whipple St",
            "address_purpose": "LOCATION",
            "city": "Eau Claire",
            "state": "WI",
            "postal_code": "54703",
            "country_code": "US",
            "telephone_number": "715-838-5222",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOUTIETTE",
        "first_name": "KAREN",
        "middle_name": "PATRICIA",
        "name_prefix": "Mrs.",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-04",
        "last_updated": "2024-12-03",
        "certification_date": "2024-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "3049-026",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kboutiette21793@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "733 W Clairemont Ave",
            "city": "Eau Claire",
            "state": "WI",
            "country_code": "US",
            "postal_code": "547016101",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Eau Claire, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.