Active NPI
Kristina Kay Warren, MOT,OT/L
- Occupational Therapist
- Springfield, IL
National Provider Identifier
1114051018
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 056008995
- Practice address
- 3050 Montvale Dr Suite a
Springfield, IL 62704-9415 - Phone
- (217) 891-1524
- NPI assigned
- Mar 15, 2007
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 31004218A | IN | |
| Occupational Therapist | 225X00000X | 056008995 | IL | Primary |
Addresses
Primary practice location
3050 Montvale Dr Suite a
Springfield, IL 62704-9415
Mailing address
4405 Lynhurst Rd
Springfield, IL 62711-7131
Phone (217) 891-1524
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200688260 | Medicaid | IN |
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 |
|---|---|---|---|
| 056008995 | IL | MD | Occupational Therapist |
| 31004218A | IN | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Brains in Motion, LLC. | Single Specialty | Current | Accepting new patients |
Locations
3050 Montvale Dr
Ste A
Springfield, IL 62704
Phone (217) 222-9302
3920 Pintail Dr
Ste B
Springfield, IL 62711
Phone (217) 891-1524
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173916800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687651200000",
"number": "1114051018",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4405 LYNHURST RD",
"city": "SPRINGFIELD",
"state": "IL",
"postal_code": "627117131",
"telephone_number": "217-891-1524"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3050 MONTVALE DR SUITE A",
"city": "SPRINGFIELD",
"state": "IL",
"postal_code": "627049415",
"telephone_number": "217-891-1524"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WARREN",
"first_name": "KRISTINA",
"middle_name": "KAY",
"name_prefix": "Mrs.",
"credential": "MOT,OT/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-15",
"last_updated": "2023-06-25",
"certification_date": "2023-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "IN",
"license": "31004218A",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Occupational Therapist",
"state": "IL",
"license": "056008995",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200688260",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Springfield, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.