Individual provider Active NPI

Holly M Gutierrez, MS, OTR

  • Hand Occupational Therapist
  • Schererville, IN
National Provider Identifier
1235462094
Registry record updated Jan 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hand Occupational TherapistTaxonomy code 225XH1200X
License
31004979A Issued in IN
Practice address
1545 W US Highway 30
Schererville, IN 46375
Phone
(219) 836-5381
NPI assigned
Sep 11, 2009
Last updated
Jan 23, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 23, 2019

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 4765-026 WI
Hand Occupational Therapist 225XH1200X 31004979A IN Primary

Addresses

Primary practice location

1545 W US Highway 30
Schererville, IN 46375

Mailing address

1545 W US Highway 30
Schererville, IN 46375-1562
Phone (219) 836-5381

Other practice location 1

929 Rockefeller Ln
Madison, WI 53704-7860
Phone (608) 807-6226

Other practice location 2

929 Rockefeller Ln
Madison, WI 53704-7860
Phone (608) 807-6226

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130904000032 IN Practitioner - Occupational Therapist in Private Practice 1254574692 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

833 W Lincoln Hwy
Suite 110
Schererville, IN 46375-1674
Phone (219) 921-1444

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
4765-026WIMDOccupational Therapist
31004979AINMDHand Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Community Care Network Inc CurrentSince Feb 1, 2019 Accepting new patients
Lakeshore Bone & Joint Institute, PC CurrentSince Dec 10, 2024 Accepting new patients
Munster Radiology Group PC PastSince Feb 1, 2019 Accepting new patients

Locations

601 Gateway Blvd N
Chesterton, IN 46304
Phone (219) 921-1401

500 E 109th Ave
Crown Point, IN 46307

9130 Columbia Ave
Ste A
Munster, IN 46321
Phone (219) 365-1166

1545 W US Highway 30
Schererville, IN 46375
Phone (219) 703-2440

833 W Lincoln Hwy
Ste 110
Schererville, IN 46375

833 W Lincoln Hwy
Ste 110E
Schererville, IN 46375
Phone (219) 427-0700

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1252627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548201600000",
    "number": "1235462094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1545 W US HIGHWAY 30",
            "city": "SCHERERVILLE",
            "state": "IN",
            "postal_code": "463751562",
            "telephone_number": "219-836-5381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1545 W US HIGHWAY 30",
            "city": "SCHERERVILLE",
            "state": "IN",
            "postal_code": "46375",
            "telephone_number": "219-836-5381"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "929 Rockefeller Ln",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "WI",
            "postal_code": "537047860",
            "country_code": "US",
            "telephone_number": "608-807-6226",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "929 Rockefeller Ln",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "WI",
            "postal_code": "537047860",
            "country_code": "US",
            "telephone_number": "608-807-6226",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUTIERREZ",
        "first_name": "HOLLY",
        "middle_name": "M",
        "credential": "MS, OTR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-09-11",
        "last_updated": "2019-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "4765-026",
            "primary": false
        },
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": "IN",
            "license": "31004979A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Schererville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.