Individual provider Active NPI

Kristie Rachelle Kapustka, COTA

  • Occupational Therapy Assistant
  • Colorado Springs, CO
National Provider Identifier
1104332956
Registry record updated Dec 15, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
OTA.0000105 Issued in CO
Practice address
5054 Farris Creek CT
Colorado Springs, CO 80924-2914
Phone
(719) 573-7808
NPI assigned
Dec 15, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 15, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X OTA.0000105 CO Primary

Addresses

Primary practice location

5054 Farris Creek CT
Colorado Springs, CO 80924-2914

Mailing address

5054 Farris Creek CT
Colorado Springs, CO 80924-2914
Phone (719) 573-7808

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

LicenseStateTypeSpecialty
OTA.0000105COMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1513296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513296000000",
    "number": "1104332956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5054 FARRIS CREEK CT",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809242914",
            "telephone_number": "719-573-7808",
            "fax_number": "719-573-7808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5054 FARRIS CREEK CT",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809242914",
            "telephone_number": "719-573-7808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAPUSTKA",
        "first_name": "KRISTIE",
        "middle_name": "RACHELLE",
        "name_prefix": "Mrs.",
        "credential": "COTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-12-15",
        "last_updated": "2017-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "CO",
            "license": "OTA.0000105",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2017; 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.