Individual provider Active NPI

Sarah Gyurina, OTR

  • Occupational Therapist
  • Kenosha, WI
National Provider Identifier
1336569201
Registry record updated Apr 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
5426-26 Issued in WI
Practice address
9244 29TH Ave
Kenosha, WI 53143-6602
Phone
(262) 694-0080
NPI assigned
Apr 18, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 18, 2014

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 5426-26 WI Primary
Occupational Therapist 225X00000X 056.010499 IL

Addresses

Primary practice location

9244 29TH Ave
Kenosha, WI 53143-6602

Mailing address

4428 S 85TH St
Greenfield, WI 53228-2806
Phone (414) 507-4315

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
056.010499ILMDOccupational Therapist
5426-26WIMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1397779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397779200000",
    "number": "1336569201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4428 S 85TH ST",
            "city": "GREENFIELD",
            "state": "WI",
            "postal_code": "532282806",
            "telephone_number": "414-507-4315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9244 29TH AVE",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531436602",
            "telephone_number": "262-694-0080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GYURINA",
        "first_name": "SARAH",
        "credential": "OTR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-04-18",
        "last_updated": "2014-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "5426-26",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056.010499",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kenosha, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2014; 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.