Kristie Lynne Porter, OTR

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

Practice address

106 Lincoln Place CT
Belleville, IL 62221-5884

Phone

(618) 236-7588

NPI assigned

Sep 26, 2007

Last updated

Sep 26, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Brefeld Physical Therapy Services PC

  • Physical Therapist
  • Belleville, IL
  • NPI 1053308015

  Occupational Therapist

  NPD (past)

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

{
    "created_epoch": "1190764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190764800000",
    "number": "1114114998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 LINCOLN PLACE CT",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622215884",
            "telephone_number": "618-236-7588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 LINCOLN PLACE CT",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622215884",
            "telephone_number": "618-236-7588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTER",
        "first_name": "KRISTIE",
        "middle_name": "LYNNE",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-26",
        "last_updated": "2007-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5330619",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD IL",
            "identifier": "0001415008",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Plastic & Hand Surgery Associates, S.C.
• Plastic Surgery Consultants, P.C. (Plastic Surgery Consultants of Illinois)
• Irina Y Polansky, PA-C
• Jamie Marie Poorman, PT, DPT
• Angel Nicole Porter
• Sally B Portera Mankins, MD
• Thomas Posnanski, LMFT
• Sobhana Krishna Potluri, MD
• Nicholas E Poulos, MD
• Chloe Powell

• Occupational Therapist in Belleville, IL
• Providers in Belleville, IL by specialty
• Occupational Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2007; 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.