Active NPI
Craig Joseph Kohlbrecher, OTR/L, EMT
- Occupational Therapist
- Trenton, IL
National Provider Identifier
1013324060
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 056.004002
- Practice address
- 1807 J Rock Rd
Trenton, IL 62293-2924 - Phone
- (618) 806-9621
- Fax
- (618) 224-9621
- NPI assigned
- Jul 22, 2014
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 056.004002 | IL | Primary |
Addresses
Primary practice location
1807 J Rock Rd
Trenton, IL 62293-2924
Mailing address
1807 J Rock Rd
Trenton, IL 62293-2924
Phone (618) 806-9621
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)
- Not enrolled
- Credentials
- Emergency Medical Technician
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 056.004002 | IL | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1405987200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1405987200000",
"number": "1013324060",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1807 J ROCK RD",
"city": "TRENTON",
"state": "IL",
"postal_code": "622932924",
"telephone_number": "618-806-9621",
"fax_number": "618-224-9621"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1807 J ROCK RD",
"city": "TRENTON",
"state": "IL",
"postal_code": "622932924",
"telephone_number": "618-806-9621",
"fax_number": "618-224-9621"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOHLBRECHER",
"first_name": "CRAIG",
"middle_name": "JOSEPH",
"name_prefix": "Mr.",
"credential": "OTR/L, EMT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-07-22",
"last_updated": "2014-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "IL",
"license": "056.004002",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Trenton, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.