Individual provider Active NPI

Carrie M Krupar, OTR

  • Occupational Therapist
  • Racine, WI
National Provider Identifier
1275754293
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
3282-026 Issued in WI
Practice address
1700 Ca Becker Dr
Racine, WI 53406
Phone
(262) 898-2804
NPI assigned
May 1, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 3282-026 WI Primary

Addresses

Primary practice location

1700 Ca Becker Dr
Racine, WI 53406

Mailing address

W167 S7987 Parkland Drive
Muskego, WI 53150
Phone (414) 422-9702

Other identifiers 1

IdentifierTypeStateIssuer
40825100MedicaidWI

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
3282-026WIMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1275754293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W167 S7987 PARKLAND DRIVE",
            "city": "MUSKEGO",
            "state": "WI",
            "postal_code": "53150",
            "telephone_number": "414-422-9702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 CA BECKER DR",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "53406",
            "telephone_number": "262-898-2804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUPAR",
        "first_name": "CARRIE",
        "middle_name": "M",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "3282-026",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40825100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Racine, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.