Active NPI
Nathan David Rieder, MOT OTR/L
- Occupational Therapist
- Kankakee, IL
National Provider Identifier
1033474440
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 056.006688
- Practice address
- 500 W Court St
Kankakee, IL 60901-3661 - Phone
- (815) 937-8220
- NPI assigned
- Jul 11, 2012
- Last updated
- Jul 11, 2012
- 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 | 056.006688 | IL | Primary |
Addresses
Primary practice location
500 W Court St
Kankakee, IL 60901-3661
Mailing address
PO Box 55
Ashkum, IL 60911-0055
Phone (815) 698-5025
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 056.006688 | IL | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1341964800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1341964800000",
"number": "1033474440",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 55",
"city": "ASHKUM",
"state": "IL",
"postal_code": "609110055",
"telephone_number": "815-698-5025"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 W COURT ST",
"city": "KANKAKEE",
"state": "IL",
"postal_code": "609013661",
"telephone_number": "815-937-8220"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RIEDER",
"first_name": "NATHAN",
"middle_name": "DAVID",
"credential": "MOT OTR/L",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-07-11",
"last_updated": "2012-07-11",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "IL",
"license": "056.006688",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kankakee, IL
- Erica Marie Reynolds, PT
- Sarah Rice, PT
- Tanya Maria Richardson-Belgrave, CNP
- Julie Richardson
- Kristen M Richardson, PHARMD
- Rincon Family Services
- River Valley Supportive Living LLC
- River Valley Supportive Living Residence LLC
- Riverside Emergency Physicians, LLC
- Riverside Health System (Psychiatric Associates)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.