Individual provider Active NPI

Charlene Krieger

  • Occupational Therapy Assistant
  • Winnsboro, TX
National Provider Identifier
1134770548
Registry record updated Sep 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
210348 Issued in TX
Practice address
406 S Main St
Winnsboro, TX 75494-3226
Phone
(903) 342-2308
NPI assigned
Sep 26, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 26, 2019

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 210348 TX Primary

Addresses

Primary practice location

406 S Main St
Winnsboro, TX 75494-3226

Mailing address

2500 Greenock CT
Tyler, TX 75703-2718
Phone (903) 279-4728

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL na

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
210348TXMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1569456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569456000000",
    "number": "1134770548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 GREENOCK CT",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757032718",
            "telephone_number": "903-279-4728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "406 S MAIN ST",
            "city": "WINNSBORO",
            "state": "TX",
            "postal_code": "754943226",
            "telephone_number": "903-342-2308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRIEGER",
        "first_name": "CHARLENE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-26",
        "last_updated": "2019-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "TX",
            "license": "210348",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "na",
            "affiliation": "N",
            "address_1": "406 S Main St",
            "city": "Winnsboro",
            "state": "TX",
            "country_code": "US",
            "postal_code": "754943226",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Winnsboro, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2019; 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.