Individual provider Active NPI

Kristina Kay Warren, MOT,OT/L

  • Occupational Therapist
  • Springfield, IL
National Provider Identifier
1114051018
Registry record updated Jun 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
056008995 Issued in IL
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

Updated by the provider on Jun 25, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 31004218A IN
Occupational TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 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

IdentifierTypeStateIssuer
200688260MedicaidIN

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
056008995ILMDOccupational Therapist
31004218AINMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew 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.

Verify at the official NPI Registry.