Active NPI
Haley Krodel, OTRL
- Occupational Therapist
- Jasper, IN
National Provider Identifier
1184965352
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 056-010042
- Practice address
- 675 3Rd Ave
Jasper, IN 47546-3602 - Phone
- (812) 351-1490
- NPI assigned
- Mar 12, 2013
- Sex
- Female
- Sole proprietor
- No
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 | 31006133A | IN | |
| Occupational Therapist | 225X00000X | 056-010042 | IL | Primary |
Addresses
Primary practice location
675 3Rd Ave
Jasper, IN 47546-3602
Mailing address
675 3Rd Ave
Jasper, IN 47546-3602
Phone (812) 351-1490
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 |
|---|---|---|---|
| 056-010042 | IL | MD | Occupational Therapist |
| 31006133A | IN | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pediatric Therapy Specialties | Occupational Therapist | Current | Accepting new patients |
Locations
675 3rd Ave
Jasper, IN 47546
Phone (812) 351-1490
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": "1363046400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1712880000000",
"number": "1184965352",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "675 3RD AVE",
"city": "JASPER",
"state": "IN",
"postal_code": "475463602",
"telephone_number": "812-351-1490"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "675 3RD AVE",
"city": "JASPER",
"state": "IN",
"postal_code": "475463602",
"telephone_number": "812-351-1490"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KRODEL",
"first_name": "HALEY",
"credential": "OTRL",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-03-12",
"last_updated": "2024-04-12",
"certification_date": "2024-04-12",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "IN",
"license": "31006133A",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "IL",
"license": "056-010042",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Jasper, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.