Joan Krystyniak-Collins, OTR

Primary specialty

Gerontology Occupational TherapistTaxonomy code 225XG0600X

License

100823 Issued in TX

Practice address

1019 Holden St
Glen Rose, TX 76043-4937

Phone

(817) 578-7479

NPI assigned

Aug 22, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1534896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534896000000",
    "number": "1013498526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11517 COUNTY ROAD 917",
            "city": "CRESSON",
            "state": "TX",
            "postal_code": "760354505",
            "telephone_number": "817-578-7479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1019 HOLDEN ST",
            "city": "GLEN ROSE",
            "state": "TX",
            "postal_code": "760434937",
            "telephone_number": "817-578-7479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRYSTYNIAK-COLLINS",
        "first_name": "JOAN",
        "credential": "OTR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-22",
        "last_updated": "2018-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XG0600X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Gerontology",
            "state": "TX",
            "license": "100823",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OT LICENSE",
            "identifier": "100823",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Gerontology Occupational Therapist in Glen Rose, TX
• Providers in Glen Rose, TX by specialty
• Gerontology Occupational Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2018; 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.