Payton Risinger, OTD, OTR/L

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

056.016228 Issued in IL

Practice address

1095 Pingree Rd Ste 209
Crystal Lake, IL 60014-1727

Phone

(847) 458-8890

Fax

(847) 458-8889

NPI assigned

Sep 10, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Gulf Breeze Physical Therapy Inc.

  • Physical Therapy Clinic/Center
  • Pensacola, FL
  • NPI 1730183153
  NPD (past)

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

{
    "created_epoch": "1725926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725926400000",
    "number": "1003642760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "431 BRANDY DR APT B",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600147470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1095 PINGREE RD STE 209",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600141727",
            "telephone_number": "847-458-8890",
            "fax_number": "847-458-8889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RISINGER",
        "first_name": "PAYTON",
        "name_prefix": "Dr.",
        "credential": "OTD, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-10",
        "last_updated": "2024-09-10",
        "certification_date": "2024-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056.016228",
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "IL",
            "license": "056.016228",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adam Joseph Rietveld, M.A., LCPC
• Mary T Riggs, DO
• Allison Riley, PTA
• Carmela Riley
• Lauren Rinn, M.A. CCC-SLP
• Carmen Rivera, BT
• Bradford C Roberg, M.D.
• Robert F Patte DPM
• Jane Robertson, LCSW
• Michael E Robinson, O.D.

• Pediatric Occupational Therapist in Crystal Lake, IL
• Providers in Crystal Lake, IL by specialty
• Pediatric Occupational Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2024; 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.