| Kimi Marie Kelly, OT | |
|
2661 S Broadway, Green Bay, WI 54304-5305 | |
| (920) 592-5262 | |
| Not Available |
| Full Name | Kimi Marie Kelly |
|---|---|
| Gender | Female |
| Speciality | Occupational Therapist |
| Location | 2661 S Broadway, Green Bay, Wisconsin |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346428414 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225X00000X | Occupational Therapist | 838-26 (Wisconsin) | Secondary |
| 225X00000X | Occupational Therapist | 383026 (Wisconsin) | Primary |
| Provider Name | Fox Rehabilitation Services Wi Llc |
|---|---|
| Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
| Provider Identifiers | NPI Number: 1518483973 PECOS PAC ID: 1658647581 Enrollment ID: O20171020002309 |
| Mailing Address | Practice Location Address |
|---|---|
| Kimi Marie Kelly, OT 2757 Nicolet Dr, Green Bay, WI 54311-7219 Ph: (920) 391-1565 | Kimi Marie Kelly, OT 2661 S Broadway, Green Bay, WI 54304-5305 Ph: (920) 592-5262 |
Ms. Joanne Mary Wirtz, MS OTR Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 1275 S Robinson Ave, Green Bay, WI 54311 Phone: 920-737-3077 | |
Mrs. Ramona Dawn Schmidt, OTR Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 1040 Pilgrim Way, Woodside Lutheran Home, Green Bay, WI 54304 Phone: 920-405-3522 Fax: 920-405-3522 | |
Jamie Lynn Mosupye, O.T. Occupational Therapist Medicare: Medicare Enrolled Practice Location: 744 S Webster Ave, Green Bay, WI 54301 Phone: 920-433-7823 Fax: 920-433-3651 | |
Mrs. Beth Lee Slippy, Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 1555 Dousman St, Green Bay, WI 54303 Phone: 920-494-4525 | |
Mrs. Lynn Mary Jadin, O.T.R. Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 2801 S Webster Ave, Green Bay, WI 54301 Phone: 920-337-1122 Fax: 920-337-1126 | |
Patricia M Slempkes, OT Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 744 S Webster Ave, Green Bay, WI 54301 Phone: 920-433-7822 Fax: 920-433-3651 | |
Ms. Tracy Strebe, OT Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 2305 San Luis Pl, Green Bay, WI 54304 Phone: 920-494-5231 Fax: 920-494-2855 |