Active NPI
Christina Rose Hagele I, COTA
- Occupational Therapy Assistant
- Richland Center, WI
National Provider Identifier
1104131887
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 4773-027
- Practice address
- 416 S Church St Apt 3
Richland Center, WI 53581-2559 - Phone
- (608) 617-2459
- NPI assigned
- Aug 18, 2010
- Sex
- Female
- 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 Therapy Assistant | 224Z00000X | 4773-027 | WI | Primary |
Addresses
Primary practice location
416 S Church St Apt 3
Richland Center, WI 53581-2559
Mailing address
416 S Church St Apt 3
Richland Center, WI 53581-2559
Phone (608) 617-2459
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 |
|---|---|---|---|
| 4773-027 | WI | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1282089600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1282089600000",
"number": "1104131887",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "416 S CHURCH ST APT 3",
"city": "RICHLAND CENTER",
"state": "WI",
"postal_code": "535812559",
"telephone_number": "608-617-2459"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "416 S CHURCH ST APT 3",
"city": "RICHLAND CENTER",
"state": "WI",
"postal_code": "535812559",
"telephone_number": "608-617-2459"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAGELE",
"first_name": "CHRISTINA",
"middle_name": "ROSE",
"name_prefix": "Miss",
"name_suffix": "I",
"credential": "COTA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-08-18",
"last_updated": "2010-08-18",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "WI",
"license": "4773-027",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Richland Center, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.