NPIMap

Organization Active NPI

Kidworks

  • Occupational Therapist
  • Chesterton, IN
National Provider Identifier
1992963813
Registry record updated May 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
31003944A Issued in IN
Legal business name
KIDWORKS
Practice address
1120 S Calumet Rd Ste 3
Chesterton, IN 46304-3286
Phone
(219) 983-9675
Fax
(219) 983-9675
NPI assigned
May 28, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 28, 2008

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

Authorized official

Name
Mr. Cynthia Suzanne Mangan
Title
Co-Owner
Phone
(219) 983-9675

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X 05008714A IN
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X 31003944A IN Primary
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X 46001702A IN

Addresses

Primary practice location

1120 S Calumet Rd Ste 3
Chesterton, IN 46304-3286

Mailing address

1120 S Calumet Rd Ste 3
Chesterton, IN 46304-3286
Phone (219) 983-9675

Other identifiers 2

IdentifierTypeStateIssuer
200861720AMedicaidIN
200837200AOtherINMEDICAID FIRST STEPS GROUP #

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1211932800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211932800000",
    "number": "1992963813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 S CALUMET RD STE 3",
            "city": "CHESTERTON",
            "state": "IN",
            "postal_code": "463043286",
            "telephone_number": "219-983-9675",
            "fax_number": "219-983-9675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 S CALUMET RD STE 3",
            "city": "CHESTERTON",
            "state": "IN",
            "postal_code": "463043286",
            "telephone_number": "219-983-9675",
            "fax_number": "219-983-9675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDWORKS",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-28",
        "last_updated": "2008-05-28",
        "status": "A",
        "authorized_official_last_name": "MANGAN",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_middle_name": "SUZANNE",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "219-983-9675",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05008714A",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": "IN",
            "license": "31003944A",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "IN",
            "license": "46001702A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200861720A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID FIRST STEPS GROUP #",
            "identifier": "200837200A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesterton, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 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.