Michael Warner, COTA

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

057001557 Issued in IL

Practice address

1790 S Fairview Ave
Decatur, IL 62521-4010

Phone

(217) 429-2551

NPI assigned

Aug 30, 2010

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1283126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283126400000",
    "number": "1154637072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 N MAIN ST",
            "city": "FARMER CITY",
            "state": "IL",
            "postal_code": "618421212",
            "telephone_number": "309-928-2619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1790 S FAIRVIEW AVE",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625214010",
            "telephone_number": "217-429-2551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARNER",
        "first_name": "MICHAEL",
        "credential": "COTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-08-30",
        "last_updated": "2010-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "IL",
            "license": "057001557",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly R Walter
• Jodi Lynn Walther, PT
• Shelby Walton, RBT
• Christine L Warchol, M.D.
• Linda L Warden-Michl, MA, NCC, LPC
• Tiffany Warner
• Jamie Sue Warnick, MD
• Wynter Warnsley
• Kaela Washington
• Tammy L Washington, LPN

• Occupational Therapy Assistant in Decatur, IL
• Providers in Decatur, IL by specialty
• Occupational Therapy Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2010; 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.